Mumps differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Nate Michalak, B.A.

Overview

Mumps must be differentiated from other diseases or pathogens that cause upper respiratory infection, prodromal symptoms, swelling of salivary glands (sialadenitis), particularly parotitis. Etiologic agents that cause similar symptoms include: parainfluenza virus, adenovirus, Epstein-Barr virus, coxsackievirus, influenza A, parvovirus B19, human herpesvirus 6. Non-infectious causes include: salivary calculi, tumor, sarcoid, Sjögren’s syndrome, thiazide drug reaction, iodine sensitivity.

Differentiating mumps from other diseases

Mumps must be differentiated from other diseases or pathogens that cause upper respiratory infection, prodromal symptoms, swelling of salivary glands (sialadenitis), particularly parotitis.^[1]^[2]^[3]

Differential diagnosis of Mumps	Symptoms					Signs			Diagnosis	Additional Findings
	Fever	Rash	Diarrhea	Abdominal pain	Weight loss	Painful lymphadenopathy	Hepatosplenomegaly	Arthritis	Lab Findings
Brucellosis	✔	✔	✘	✔	✔	✔	✔	✔	Relative lymphocytosis	Night sweats, often with characteristic smell, likened to wet hay
Typhoid fever	✔	✔	✘	✔	✘	✘	✔	✔	Decreased hemoglobin	Incremental increase in temperature initially and than sustained fever as high as 40°C (104°F)
Malaria	✔	✘	✔	✔	✘	✘	✔	✔	Microcytosis, elevated LDH	“Tertian” fever: paroxysms occur every second day
Tuberculosis	✔	✔	✘	✔	✔	✔	✘	✔	Mild normocytic anemia, hyponatremia, and hypercalcemia	Night sweats, constant fatigue
Lymphoma	✔	✘	✘	✔	✔	✘	✔	✘	Increase ESR, increased LDH	Night sweats, constant fatigue
Mumps	✔	✘	✘	✘	✘	✔	✘	✘	Relative lymphocytosis, serum amylaseelevated	Parotidswelling/tenderness
Rheumatoid arthritis	✘	✔	✘	✘	✘	✘	✘	✔	ESR and CRP elevated, positive rheumatoid factor	Morning stiffness
SLE	✘	✔	✘	✔	✔	✘	✘	✔	ESR and CRP elevated, positive ANA	Fatigue
HIV	✘	✘	✘	✔	✔	✔	✘	✔		Constant fatigue

References

↑ Davidkin, Irja; Jokinen, Sari; Paananen, Anja; Leinikki, Pauli; Peltola, Heikki (2005). “Etiology of Mumps‐Like Illnesses in Children and Adolescents Vaccinated for Measles, Mumps, and Rubella”. The Journal of Infectious Diseases. 191 (5): 719–723. doi:10.1086/427338. ISSN 0022-1899.
↑ Gupta, R. K (2005). “Mumps and the UK epidemic 2005”. BMJ. 330 (7500): 1132–1135. doi:10.1136/bmj.330.7500.1132. ISSN 0959-8138.
↑ Mumps. Centers for Disease Control and Prevention (May 29, 2015). http://www.cdc.gov/mumps/index.html Accessed March 08, 2016.

Overview