What is the treatment for a patient with mumps?

Treatment of Mumps

Mumps treatment is entirely supportive and symptomatic, as there is no specific antiviral therapy available for this self-limiting viral infection. 1, 2

Primary Symptomatic Management

The cornerstone of mumps treatment involves pain and fever control with acetaminophen or NSAIDs to manage fever, headache, and parotid gland pain. 1, 3 This symptomatic approach is the only intervention needed for most patients, as mumps disease is generally self-limiting and most patients recover without intervention beyond supportive care. 1

Hydration and Dietary Modifications

• Ensure adequate fluid intake, as parotitis makes swallowing uncomfortable and painful. 1, 3
• Recommend soft foods and avoid acidic foods that stimulate salivary flow and worsen parotid pain. 1

Isolation and Infection Control

Implement droplet precautions immediately and isolate patients for 5 days after onset of parotitis, as patients are contagious from 7 days before through 8 days after parotitis onset. 1, 3 This isolation period is critical to limit spread to susceptible contacts. 1

• Educate patients and family members about transmission through respiratory droplets and direct contact with saliva. 1, 3

Monitoring for Complications

Complications are more common and severe in adults than children, making age an important consideration in monitoring intensity. 1 Be aware that parotitis is not present in all cases—only 30-40% of mumps infections produce typical acute parotitis, while 15-20% are asymptomatic and up to 50% present with nonspecific or respiratory symptoms. 1

Neurological Complications

• Monitor for aseptic meningitis (occurs in 4-6% of cases), characterized by severe headache, neck stiffness, photophobia, or altered mental status. 1, 3
• Watch for signs of encephalitis, including seizures, paralysis, or cranial nerve palsies, which can cause permanent sequelae. 1, 3
• Assess for hearing loss, including sudden sensorineural deafness, which was a major cause of childhood deafness in the pre-vaccine era. 1, 3

Reproductive System Complications

• Assess for orchitis in postpubertal males (occurs in up to 38% of cases), characterized by testicular pain and swelling, though sterility is rare. 1, 3, 4
• Monitor for oophoritis (ovarian inflammation) in postpubertal females. 1

Other Systemic Complications

• Watch for pancreatitis, characterized by severe abdominal pain, nausea, and vomiting. 1, 3

Special Consideration: Facial Nerve Involvement

If facial droop or weakness develops due to facial nerve inflammation:

• Initiate corticosteroid therapy promptly with prednisone 1-2 mg/kg/day for 5-7 days followed by a taper over 5-7 days to reduce inflammation and improve nerve function. 1, 5
• Provide eye protection to prevent corneal damage if facial weakness prevents complete eye closure. 1, 5
• Reassure patients that complete recovery occurs in approximately 70-80% of cases within 3-6 months. 1, 5

Important Clinical Caveats

• No specific antiviral therapy exists for mumps—treatment with interferon alpha-2b has been suggested specifically for mumps epididymo-orchitis in research settings, but this is not standard practice. 6
• Intravenous immunoglobulin therapy may have a future role in mumps management, but this remains investigational. 6
• Antibiotics have no role unless bacterial superinfection (such as bacterial orchitis) cannot be excluded at initial presentation. 4
• Most patients recover without intervention beyond the supportive measures outlined above. 1