Treatment

There is no specific treatment for mumps and management is, in general, supportive and based in the primary care setting.

• management of orchitis
  • testicular atrophy and, irreversible infertility, may develop in 40-70% of cases of severe bilateral mumps orchitis
  • consult urological advice - especially if bilateral orchitis
    • ice packs to the scrotum can help relieve the pain associated with orchitis - scrotal support (e.g. an adhesive bridge) and nonsteroidal anti-inflammatory agents may provide symptomatic benefit (1)
    • corticosteroids may decrease the pain and oedema - however corticosteroid use has been found to cause testosterone levels to decrease and FSH and LH levels to increase (2)
    • early incision of the tunica vaginalis and drainage of the hydrocoele may avoid the development of testicular atrophy in most patients - however infertility may still occur in 12% to 30% (3)
    • there is evidence that systematic treatment with interferon-alpha-2B does reduce the incidence of testicular atrophy - however this treatment modality does not seem completely effective in preventing testicular atrophy after mumps orchitis (3)

Other significant complications such as meningitis, encephalitis, nephritis and pancreatitis require specialist review.

Effective post exposure prophylaxis for mumps is not available. In individuals exposed to mumps virus, vaccination will not prevent progression to infection (4).

Reference:

• (1) Masarani M et al. Mumps orchitis. J R Soc Med 2006;99:573-575
• (2) Adamopoulos D.A. et al (1978).Pituitary testicular interrelationships in mumps orchitis and other viral infections. BMJ ;1:1177?1180
• (3) Yeniyol CO et al (2000). Role of interferon-alpha-2B in prevention of testicular atrophy with unilateral mumps orchitis. Urology;55(6):931-3.
• (4) Gupta R.K et al. Mumps and the UK epidemic 2005. BMJ. 2005;330(7500):1132–1135