The characteristic presentation of mumps is tender, swollen parotid glands. Inflammation of submandibular and sublingual salivary glands is palpable in 10% of patients. Sialoadenitits is usually preceded by a low-grade fever. The jawbone is often not palpable and swelling pushes the angle of the ear out and up. 25% of patients present with unilateral swelling. Stensen’s duct orifice may be inflamed and erythematous. Lymph node swelling can be differentiated by the well-defined borders of the lymph nodes, location behind the angle of the jawbone, and lack of the ear protrusion or obscuring of the jaw angle.

• Low-grade fever

• Tender, edematous salivary glands

• Swollen parotid glands (90% of patients)
• Swollen submandibular and sublingual glands (10% of patients)

• Swelling pushes angle of ear up and out
• Jawbone below ear often not visible or palpable at peak inflammation
• Patients may present with unilateral parotitis

• One parotid may swell before other
• 25% of patients only have unilateral swelling

• Stensen’s duct orifice may be inflamed and erythematous
• Lymph node swelling can be differentiated by well-defined borders of the lymph nodes, location behind the angle of the jawbone, and lack of the ear protrusion or obscuring of the jaw angle^[1]

• 
  Child with parotitis. Adapted from the CDC.^[2]

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