Mumps (mumps): treatment

Parotitis (Mumps)

Mumps, or, as they call the patients, mumps - an acute infectious viral disease with a primary defeat of glandular organs and / or nervous system, accompanied on this background, fever and general intoxication.

Hippocrates described the mumps, but only in 1934 was formed the final of the symptoms and the viral nature of the proof of the pathogen.

Some people believe that the name comes from two Greek and Latin phrases: para-about and otos- ear and ending -its- indicates inflammation.

Thus, the name reflects the most common site of inflammation - the parotid gland.

The causative agent of mumps

Pathogen mumps (Parotits epidemica) - RNA virus belonging to the family of paramyxoviruses and the corresponding characteristic parameters this family: large-sized irregular spherical shape, typical for this family of antigenic structure - N (neuraminidase) and H (Hemagglutinin). N - fixing and causes further penetration of the virus through the mucous membranes of the upper respiratory putoy; H - causes adhesion and destruction of red blood cells.

The virus is relatively stable in the environment: stored at room temperature for several days at low temperatures up to 6 months. Specific virus inactivation occurs upon heating to 80⁰S for 30 minutes, also has detrimental effect of UVB, 1% Lysol solution and a 2% formalin solution and other disinfectants.

The prevalence of mumps

The infection is recorded throughout the year, with the rise of the incidence in winter and spring. Propagation ubiquitous and susceptibility reaches 50%.

The highest incidence is observed from 3-6let children first year of life, which are a natural feeding, resistant to the virus due to passive immunity produced by maternal IgA, providing first line of defense. People neimmunnizirovannye retain susceptibility life.

Infection is formed after undergoing a strong immunity. After vaccination, forming a strong immunity for 20 years.

Causes of mumps

Source - a sick man, mumps virus isolation begins in the incubation period, which asymptomatic, namely 1-2 days until obvious symptoms, and after 8 days after clinical manifestations.

Modes of transmission - airborne, contact-household (through saliva contaminated household items). Infection facilitates population density, background respiratory diseases and immunodeficiency (CID).

symptoms of mumps

incubation period 9-26 days (average 15-19) - is characterized by the absence of any clinical manifestations. During this period, fastening and virus replication in the upper respiratory tract mucosal after which the concentration reaches a maximum, and it breaks into the blood - occurs primary viremia.

This gives the start to the acute onset - fever in the evening to 38-40⁰S and intoxication (malaise, muscle and joint pain). During the first days of the onset of the disease there is an increase in the parotid gland, and in another second day affected salivary gland. In the early stages affects the parotid and / or submandibular.

Mumps lesions in the early stages

It should be noted that not itself affected glandular tissue, and the tissue around the excretory duct, ie, is their blockage, which leads to the formation of the following symptoms:

• dry mouth; • soreness and increase in place of the projection of the affected breast;

• tenderness of affected area, it is soft in consistency, the dough, so the outer edema has no clear boundaries.

With the accumulation of the pathogen in the tissues glands and maximize its number of virus breakthrough occurs and re-entering it in the blood - secondary viremia. After that, by hematogenous (blood), the virus reaches the other glands and / or nerve tissue, which will generate the following symptoms steps. There are:

• The defeat of testicles in boys - orchitis, girls - oophoritis (since they too are glandular tissue): pain in the abdomen, of referred to the scrotum and testes, after which they sealed and there is a sharp pain due to disturbances of the excretory ducts, as in any other glandular tissue, scrotal skin becomes congested with cyanotic shade. Symptom 1.5 passes through the week, on average.

Mumps infection. Bilateral orchitis

• The defeat of the brain and spinal cord (aseptic meningitis): develops in 3-5 days from the date of destruction of the salivary glands, and there is a change of places of symptoms - mumps abates, and the general condition is deteriorating: - a new temperature rise to 38-39⁰S - lethargy and weakness - headache, against which may experience nausea and vomiting, not bringing ease

- become positive meningeal signs (neck stiffness - in the supine position can not touch your chin to the sternum; Brudzinskogo symptoms - an attempt to tilt the head to the chest, causing flexion in the knee / hip joints; Kernig symptom - a violation of straightening the bent leg at the knee joint) - when these symptoms require immediate hospitalization!

• Polyneuropathy (multiple lesions of the peripheral nerves): - compression of the facial nerve, resulting in disruption of facial muscles or neuralgia (severe pain, shooting character) -with lesion of the parotid gland - paralysis of the lower limbs and / or pain (for poliradikulonevrapatii) - resistant hearing loss (Cochlear nerve damage) • Defeat the pancreas (pancreatitis) develops in 5-9 days from the first symptoms - a new rise of temperature on the background of the general deterioration, - nausea and vomiting, which brings relief - abdominal pain / left hypochondrium with irradiation (spreading pain) in the back, or zoster character

- liquid fatty stools at the younger age contingent, and the presence of constipation in older age groups.

recovery period It comes after the disappearance of symptoms - in about 9 days.

diagnosis of mumps

1.Obktivny method (examination), taking into account information about the contacts with possible infectious bolnymi.2.

Laboratory diagnosis: • Virological - the use of biological materials which may be a virus: urine, saliva and cerebrospinal fluid, but not within 5 days of illness • IFA (immunofluorescence reaction) is a rapid method and to determine the virus in tissue cultures after 2 days from the date of • sampling Serological methods detect the presence of Al (antibodies), - RAC (complement fixation) - is considered the most highly specific and sensitive method, by which to determine the presence of antibodies or antigen-s-v-antigen, and thus define the period or degree of morbidity protivoparatitnoy immunization; The presence of antibodies to the s-antigen talks about the acute period, and the presence of antibodies to v-antigen says about the period recovery if it is in high titers, if low titers (compared to antibody to s-antigen) - the acute phase disease. - HAI (hemagglutination inhibition) - assayed for antibody titer; - RN (neutralization reaction) - will indicate the qualitative and quantitative ratio of antibody (or antitoxin) and antigen (or antitoxin)

- EIA (enzyme immunoassay) - determination of immunoglobulins IgM and G, by which the period of the disease is determined: M - speaks of acute period, G - a process stihanii.

mumps treatment

1. Bed / polupostelny mode.
2. Gentle vitaminized diet except obligate allergens (all artificial comprising many chemicals and dyes) + excessive drinking; Vitamins can be in the form of tablets or dragees.
3. Causal treatment (against the causative agent): Antiviral (izoprinozin -on 50-100mg / kg / day divided into 4 reception and receive within 7-10 days) immunomodulators (interferon - intranasally to 5 drops every 30 minutes for 4 hours in the following days - 5 times a day for 5 -7 days viferon - on 2 candles per day); immunostimulants (tsikloferon- used only starting from 4 years: 1 tablet / day, 7 years - 2 tablets adults - 3 tablets).
4. Antipyretics (drugs of the NSAID -paratsetamol / ibuprofen / nurofen, in the absence of contraindications).
5. dry heat to the affected gland

Upon accession, the nervous form of the infection (meningitis and / or polyneuropathy) to the above-mentioned hospital added some more group preparations and transferred to inpatient treatment, because when assigning some drugs should be carried out laboratory the control:

1. Strict bed rest.
2. Dehydration, detoxification and glucocorticosteroid therapy (to prevent swelling of the brain and / or sdevleniya peripheral nerve due to swelling of other glands) - diakarb and furosemide in combination with drugs potassium.
3. Drugs improving cerebral blood flow and metabolic activity (aktovegin, Trental, agopurin etc.).
4. Vitamins C, E and PP-acid

When joining is conducted orchitis observation by the surgeon, when performing the standard therapy Registered

With the development of pancreatitis is assigned to bed rest, and in the first 2 days of illness - hungry days (complete refusal of food intake and the introduction of nutrient preparations only parenterally, ie, intravenously), and then gradually move on to an easy diet - a table №5 fractional Power.

1. to standard therapy, which is represented above - administered inhibitors of proteolytic enzymes (contrycal, gordoks etc.) - unnecessarily due to clogging of outlet ducts occurs "samoperivarivanie" gland due to own enzymes
2. Non-narcotic analgesics and spasmolytics (spazmalgon, ketorolac)
3. enzymatic agents to improve digestion, because liver enzymes for the same reason cease to flow blockage to the duodenum; to that end, appoint pancreatin mezim forte, enzistal

The glandular form of mumps can be treated at home, but any other manifestation (orchitis, meningitis, polyneuritis, pancreatitis) should be treated only in a hospital. The duration of treatment on average - 2 weeks

After suffering mumps

Rehabilitation is convalescent dispensary observation, the duration of which depends on the shape mumps infection: • When adjourned meningitis - surveillance for a month in a clinic, and then for the past 2 years; repeated neurological examination and electrophysiological intervals 1,3,6 months; restriction of physical and mental stress during the year • for the postponed orchitis (oophoritis) - endocrinologist observation throughout the year

• pancreatitis - observation pediatrician and / or gastroenterologist

complications of mumps

Encephalitis, brain swelling deaths, infertility in both men and women (related to the transferred inflammation of the sex glands at an early age), the development of diabetes, unilateral hearing loss without recovery. More mortality in 2000 was 1.5%.

Prevention of mumps

• isolation of patients at 10 days • isolation of unvaccinated contact for 21 days

• active immunization by vaccination DRI (live mumps vaccine), or MMR-II (measles, mumps, rubella) - is carried out in the first 12 months and then 6 years.

4-12 days after vaccination may have fever and a slight increase of the parotid salivary glands. Vaccinations are carried out taking into account all contraindications.

And you do not enter the vaccine to those who received the immunization as an immunoglobulin, its introduction is delayed for a certain period, which is set by your doctor.

Doctor therapist Shabanova I.E

A source: https://medicalj.ru/diseases/infectious/753-parotit-svinka

parotitis

Mumps - an inflammatory disease of the parotid gland infection or neuroendocrine nature.

The name comes from the Latin name of the salivary gland glandula parotidea. Inflammation is known as mumps.

Classification

Inflammation of the salivary glands caused by a bacterial, viral, fungal infections of character.

According to the clinical picture distinguish:

• specific mumps - virus (Mumps), tuberculous, aktinomikotichesky;
• non-epidemic mumps or purulent.

acute mumps

A distinction is also mumps, acute and chronic. Acute inflammation corresponds to a primary infection, caused usually one pathogen.

Acute mumps virus origin is often the virus mumps - mumps. Acute bacterial parotitis develops as a result of activating the bacterial flora in the oral cavity, salivary gland ducts.

The cause of acute bacterial mumps may be a violation of secretion of saliva in the parotid gland.

By flowing forms distinguish serous acute mumps, festering, gangrenous. When serous mumps salivary gland tissue to swell, in the excretory ducts accumulate secret.

Stagnation of saliva helps to activate microflora. Saliva released a little skin over the gland is not changed, the patient is usually satisfactory.

The next stage of the inflammatory process - purulent parotitis. At this stage there are areas of purulent fusion gland tissue.

The skin over the gland is inflamed, red, shiny. Ill patients open mouth, thick, sharply painful on palpation of the gland.

In the propagation process acute purulent otitis enters gangrenosum form, wherein purulent fusion of tissue covers the entire gland. After breakthrough septic foci fistula formed through which are removed the necrotic tissue.

Perhaps you were looking for information on acute otitis media? Read more in our next article Acute otitis media in a child: causes, symptoms, treatment.

chronic mumps

Usually occurs as a primary disease is rarely an acute complication of mumps. Chronic mumps is a manifestation of Sjogren's syndrome or Mikulicz syndrome.

Sjogren's syndrome - inflammation affecting mucous membranesCharacterized by a decrease in the secretion of mucous glands. When observed Sjogren syndrome dry eye, mouth due to lack of saliva, lacrimal fluid.

Mikulicz syndrome is manifested in the increase of the volume of the salivary glands, Increase in saliva secretion. Swollen glands capable of reaching such an extent that interferes with talking, eating.

Swelling of the salivary glands and arching pain observed in chronic angiosialitis. Changes observed in the ducts and glands, accompanied by the release of the secret with lumps of mucus.

chronic mumps It manifested in proliferation of connective tissue, glandular tissue replacement, reduced saliva. Symptoms of chronic mumps expressed slightly, often no symptoms.

In exacerbations marked dry mouth, swollen glands, saliva pus with massaging.

The occurrence of chronic mumps associated with metabolic disorders, the disease occurs with periodic exacerbations, does not cause serious complications.

Mumps - Mumps

The disease causes the filter paramyxovirus Mamps virus. Infection affects mainly children from 3 to 16 years. The boys are ill twice as often as girls.

Mumps can get sick at any age, but much less frequently. Men get sick more often than women, adults mumps proceeds particularly hard, with severe complications.

You can become infected only humans, animals are not carriers of the virus. Infection occurs by droplets when sneezing, conversation.

Enhances the infectivity of mumps, colds, flu, so there is a seasonal disease. Outbreaks of mumps are observed in the cold season.

Mumps on Classification of Diseases ICD 10 relates to a highly contagious disease. Sick pig is dangerous to others on the second day after infection, during illness and for two weeks after recovery.

If mumps is not a purulent inflammation of the tissues. The virus causing the pig unstable, loses activity upon irradiation with ultraviolet light, heating, treatment Lysol, formalin.

After suffering mumps immunity produced. The incubation period ranges from 13 to 19 days, deviations - 3-4 days.

symptoms

The first symptom of mumps is stomatitis - inflammation of the oral mucosa. Harbingers of pigs is muscle pain, chills, feeling of weakness, headache.

Inflammation of the parotid gland, caused by trauma, salivary duct obstruction, accompanied salivary colic - paroxysmal pain in the gland.

A sign of infection of the salivary glands are a pain when chewing, pain behind the ear lobe.

Almost immediately swelling appears on one side face, the temperature rises above 38 degrees, the bulged earlobe.

With palpation pain before tragus of an ear, in BTE region, at the edge of the mandible. Typical symptoms of mumps - pain when chewing, dry mouth.

Observed changes in the gastrointestinal tract, heart, nervous system and eyes.

Depending on the degree of target organ lesions observed:

• loss of appetite, negative attitude to Tabasco in food, vomiting, nausea, constipation or diarrhea (in children);
• shortness of breath, palpitations, chest pain;
• meningitis, fatigue, mental disorders;
• optic neuritis, an inflammation of the lacrimal gland, otitis media.

Diagnostics

Mumps diagnosed according radiosialografii, a method to evaluate the features of operation of the salivary gland. In the diagnosis of mumps used ultrasound parotid glands, cytological analysis of saliva composition.

To confirm mumps conduct testing in specialized laboratories vitro - from the Latin. in vitro name, which means "out of the living."

Specific analysis on mumps is to determine the presence of IgM and IgG. IgM are found on the third day after infection, sometimes before the appearance of symptoms of mumps.

IgG is found in the blood after the onset of symptoms of mumps. Sufficient to maintain life-long immunity IgG level is maintained throughout life.

Mumps is differentiated from false mumps - psevdoparotita Herzenberg. In this disease affects the lymph nodes in the salivary gland. The ducts of the salivary gland and its tissue is not involved in inflammation.

Treatment

Mumps is treated at home. The patient should be isolated during treatment, quarantine in children's institutions when it detects pig is three weeks.

Disinfection with infectious mumps is not carried out, in order to prevent complications of the patient must be at least 10 days to comply with bed rest. Shows soft degitratatsionnaya therapy, dairy food, light diet.

And non-epidemic mumps treated conservatively and surgery. By conservative treatment refers frequent rinsing the mouth with water, acidified with lemon juice, diet comprising food caused by active secretion of saliva.

Details about the procedure mouthwash read our article on the example of chlorhexidine mouth rinse.

Simultaneously, the patient receives a drop of 1% pilocarpine solution - 8 drops per meal for breakfast, lunch and dinner. Appoint sulfonamides, penicillin antibiotics. Ducts of the salivary gland was washed with chymotrypsin.

On gland applied hot compress is irradiated with ultraviolet light, is applied UHF therapy solljuks.

For the treatment of mumps used interferon. It is administered intramuscularly once a day for 10 days. Interferon irrigate the oral cavity several times a day, spend restorative therapy.

When purulent parotitis in the absence of a positive result of treatment with resort to surgery.

Patient make two cuts to cleanse the tissues of pus:

• incision of the skin and subcutaneous tissue at the back edge of the lower jaw;
• along the cheekbones.

The evacuation of pus improves the condition of the patient, inflammation stops. In frail patients can not always stop the process and after surgery.

In the propagation of inflammation in the neck tissue temperature continues to be kept high, the patient is threatening sepsis.

complications

In children, a complication of mumps may be inflammation of the testicles in boys with atrophy and possible infertility later.

The girls may be inflammation of the ovaries, mastitis. Mumps during pregnancy can cause the death of the child, his infection.

Heavy flows mumps in adults is complicated by meningitis, diabetes, infertility, deafness.

In acute purulent parotitis there is a danger of purulent fusion of large blood vessels, inflammation and facial nerve paresis partial facial muscles. Pus able to break into the ear canal, to cause thrombosis of the jugular vein.

prevention

Prevention of mumps vaccination is associated vaccine for measles, mumps and rubella - PDA. Vaccinations are a year and 6 years.

Stimulation of the saliva by means mouthrinse weak solution of baking soda, or Citric acid is the prevention of acute during seasonal outbreaks of infectious diseases mumps.

Forecast

When serous acute mumps favorable prognosis. Purulent and gangrenous mumps cause a decrease in salivary gland function. Mumps, uncomplicated, has a favorable prognosis.

Positive outlook with regard to chronic mumps. Although full recovery does not occur, hygienic oral care is beneficial to the health of the patient.

Video of mumps - mumps

A source: https://loramed.ru/bolezni/uho/parotit.html

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Ask the doctor

Mumps or mumps - a viral infection that occur with a primary lesion of glandular organs - especially the typical and obvious is the loss of the salivary glands.

But it is not true any seal in the ear automatically assume mumps, as in the ear and the angle of the mandible there is a set of anatomical structures that can provide similar symptoms.

In addition, rare, but mumps can occur without & destruction of the salivary glands.

Mumps usually affects children between the ages of 3-5 to 12-14 years, but mumps can develop in adults, usually up to a year children mumps do not get sick, they are protected by innate immunity.

Where the disease?

Mumps is caused by a particular virus, which belongs to the paramyxovirus family. The virus is sufficiently sensitive to drying and heating, solutions for disinfecting action. But the cold is well preserved - so often Mumps occurs at low temperatures in the offseason.

You can become infected only by the sick person or the person with carriage or erased symptoms. Moreover, these children and adults play a crucial role in the spread of infection.

Sick pig kids become dangerous to others and contagious two days before the first signs of the disease, and their infectivity lasts throughout the first week of life.

mumps viruses are transmitted through the air - when talking, kissing, coughing or sneezing, can be passed from child to child through objects and saliva when using shared toys or spoons. Susceptible to the disease, almost all children are not vaccinated or without a history, but the boys are ill twice as often as girls mumps.

As the disease develops

The virus enters the body through the so-called "entrance gate" of infection - is the mucous membranes of the nose or throat.

From there, they enter the bloodstream through the lymphatic and blood capillaries and distributed in various glandular bodies - parotid, submandibular and sublingual salivary glands and other glandular organs (pancreas, sexually authorities). The incubation period is at mumps average 11-21 day.

Viruses are mainly coming from the patient with the saliva, so mumps infection need close and intimate contact. To particles of saliva may fall off to another child, it is usually caused outbreaks in children's groups or institutions. Usually mumps revealed seasonal, with a peak in the autumn-winter season.

After an illness generated proof lifelong immunity, repeated episodes of illness does not happen. Children up to six months formed passive immunity from the mother in the form of its antibodies, and they do not get sick.

How does mumps

The first signs of mumps as a variety of other respiratory diseases children are temperature rise to high numbers - an average of 38-39 ° C, and general malaise lethargy, weakness. Shaped swelling in the parotid gland, mostly on one side, sometimes on both.

Due to the swelling and tenderness swelling formed during chewing or mouth opening. a typical location of the tumor is in the angle of the mandible and around the mastoid process. When the feeling is like the consistency of the dough, can be painful, but the skin over its surface are not changed.

Due to the swelling of the salivary glands of the baby's face becomes puffy and characteristic rounded shape, and from this comes the name of the disease.

Place exit ducts of the salivary gland strongly reddens and swells, there being a violation, headaches, decreased appetite, and pain in the stomach area.

In a certain part of the children involved in the lesion area of ​​the submandibular and sublingual salivary glands, it is manifested as the appearance testovidnyh formations in the area of ​​the lower jaw and chin.

They are quite painful, swollen glands gradually to 4-5 days of illness increases to the maximum, and then gradually to 10 day is on the wane.

The inflammation of the oral cavity saliva current is broken, since the main function of the saliva of the mouth cavity is cleaned of plaque and saturate teeth child mineral components, these functions are violated. This increases the risk of caries.

Furthermore, due to the constant presence in the cavity of the large amounts of microorganisms and as appropriate acidic medium, reproduction begins active microorganisms. Often joined by gum disease - gingivitis.

In addition to the oral cavity and gingivitis may develop infectious disease, because saliva does not carry out its antibiotic function.

What to do?

If mumps is subjected to shock only the area of ​​the salivary glands, usually recommended to treat the child at home. First. What is recommended to do - is to isolate the child from all others, especially children and without a history of mumps.

The child is allocated a separate room, which should be aired regularly, ideally every two hours, and well cleaned. It is recommended to do daily wet cleaning with any modern disinfectants. If possible, wash and wash all the toys your baby as it does not exclude the transfer of diseases through saliva with toys that children pull in the mouth.

All linen and baby clothes as well as his dishes should be boiled - the virus is killed by heat. At the time, until his salivary gland swollen, recommended the observance of a toddler bed rest, at least for a time, fever and general poor health.

Usually the first three to five days, when the tumor grows and glands are painful, the process is completed in about 7-10 days. But if the kid does not want to lie down all the time and there is no temperature. You may go to polupostelny and home modes. For inflamed glands shown constant warming and being in heat.

At low temperatures up to 38 degrees, most are optimal alternation poluspirtovogo compress or oil. Initially, the area glands covered with a layer of gauze, which is soaked with alcohol diluted in half or vodka or impregnated camphor oil, and then covered with a layer of parchment or polyethylene film.

Next, a layer of wadding is applied and not all together tightly pribintovyvayut a couple of hours. Breaks between compresses are typically an hour, this time the baby is resting or eating, but if a child is ill their transfers, fever or do not want to do compresses flatly, you can simply wrap your neck warm woolen scarf.

When inflammation of the glands of the child uncomfortable to eat, especially chew it, there is soreness. Therefore, it is necessary to revise the crumbs of food - usually give him boiled and mashed, and semi-liquid food, mostly preferred milk and vegetable dishes, eliminating the annoying and sharp, spicy dishes.

If dry mouth is useful to drink boiled water baby, but not cold and not hot, you can give your child herbal teas, fruit drinks or juices diluted with water, weak tea. useful mouth rinse baking soda solution - a prophylaxis of oral infections and humidifying it furthermore - soda solution reduces virus activity.

mumps danger is not in the swelling of the salivary glands, although it is uncomfortable for the child. Mumps is dangerous for its complications. If the parallel with the salivary glands are not affected other glandular organs, the disease stopped after 10-12 days. However, eating on the go, you can walk. That's hurry to kindergarten or school should not be - the child is still difficult. He weakened after an illness and can easily acquire new infections, it is necessary to wait at least another week.

complicated forms

parotitis - a very insidious disease, in addition to the salivary glands, and it affects many other organs, and the manifestation of these lesions are much more serious than swollen glands in the neck. One of the most frequent complications - a pancreatic lesion to the development of pancreatitis.

This painful disease, especially for a small child - it starts with a high temperature and deterioration of the general state, there are abdominal pain, sharp character, especially in the umbilical sector or appears herpes nature of pain.

In addition, there are nausea and vomiting, diarrhea, or delays the chair.

If in addition to the increase in salivary glands appeared similar symptoms - can not be treated at home - it is dangerous and requires an ambulance and hospital. When mumps pancreatitis often become purulent accompanying appendicitis or enzymatic destruction of a part of the pancreas.

These conditions are lethal for a child. an accurate diagnosis and, if necessary, immediately operate the baby can only be in the hospital.

It is impossible to try to anesthetize the ambulance kid, give him a pill or doing enemas, hot-water bottles and ice on my stomach, it is not necessary to force a child to eat - let alone drink, if you want, as if you have diarrhea and vomiting may develop dehydration.

After the hospital the child still need and dieting, as pancreatitis - a breakdown of the entire intestinal enzyme system, and unloading require dietary restrictions.

Another complication

Another serious and very serious complication is loss of sexual organs - testes in boys and ovaries in girls. The girls happily suffer rare, but the boys all the more difficult. Suspected complications can easily and parents - or both testicles area swells, the skin becomes red and shiny, a child is sick, the touch of testicular tissue is similar to the dough.

But if a little boy - you will see it, and if that child is older - it can feel embarrassed and hide the pain, you need to urgently examine the son. Boys may complain of abdominal pain, immediately interrogate the husband or themselves delicately look in panties.

Usually there is one sequential loss first, and after a couple of days and second testicular failure rarely happens immediately bilateral or insulated on one side. If these symptoms are found - immediately need a doctor, you can not treat yourself inflammation - it threatens to further infertility boy over the death of testicular tissue.

Until the arrival of the doctor is necessary to give the child a pain reliever Nurofen by type or paracetamol and lay in bed, in addition, you need to make bandages gamachok for eggs, securing the ends of the belt. This device allows you to lift and hold the weight in the swollen testicles, which relieves pain.

Testes in any case can not be warming, forbidden packs - you can make a bubble with cold water, but not ice. You can not smear any skin ointments and creams, do not wipe any lotions.

But the most dangerous complication of mumps - is the development of meningitis, an inflammation of the brain and spinal cord.

It begins at 5-7 days from the date of destruction of the salivary glands and is manifested by a sharp violation of state, headaches, regidnostyu - dramatic tension neck muscles and vomiting.

The head tilts and disturbed consciousness, possible convulsions. With the development of this immediately call an ambulance - a condition requires immediate assistance.

Before the arrival of the ambulance can be allowed reception diuretic - diakarba or furosemide to slightly reduce swelling, put the baby on the floor with cramps development, and to the side, so that in case of vomiting, he breathed vomitus.

If there is no diuretic may be given medication for headaches, but nothing can be taken. In the hospital the child be placed in the intensive care unit, will carry out anti-inflammatory and decongestant activity, and an average of meningitis is treated for 10-12 days.

On prevention of the disease and vaccination against mumps will be discussed in a separate article.

A source: https://puzkarapuz.ru/content/226

Epidemic parotitis (Mumps)

Epidemic parotitis (parotitis epidemica; Synonym: mumps, mumps, mumps infection) - an infectious disease characterized by lesions of glandular organs and (or) of the nervous system.

Allocate the typical and atypical forms (erased and asymptomatic) mumps. Typical forms: glandular - isolated lesion only ferruginous bodies (parotid, submandibular gland, testis, and others.

); nervous - just isolated lesion of the central nervous system (aseptic meningitis, meningoencephalitis); combined - damage to the central nervous system and the glandular organs (serous meningitis combined with mumps or submaksillit in combination with pancreatitis and meningoencephalitis and other combination).

Depending on the severity of the changes glandular organs, the central nervous system and the general intoxication distinguish between mild, moderate and severe.

The incubation period - 11-23 days (on average 18-20 days). In typical cases, the disease usually occurs in moderate form starts sharply with increasing temperature to 38-39 ° and above.

There is swelling and tenderness of the parotid glands, at first, as a rule, on the one hand, and in 1-2 days - and the other. Intoxication expressed moderately.

In some cases, for 1-2 days until the swelling of the parotid glands are observed prodromal phenomena (malaise, lethargy, headache, sleep disturbance).

parotid gland disease (which is observed most often) seen an increase in its size; palpation iron testovatoy consistency with the seal in the center, is painful.

The increase of the parotid gland protruding from the branches of the lower jaw, swelling extends forward and backward on the cheek, doing a hole between the mastoid and mandible. With a significant increase of the parotid glands ottopyrivayutsya ears and earlobe rises to the top.

A person takes a distinctive look, and therefore the disease was called "pig." The skin in the area of ​​increased salivary gland tight but not hyperemic. Sometimes there is swelling of the subcutaneous tissue surrounding the salivary gland. The patient hardly opens his mouth and complains of pain when chewing.

In the oral mucosa on ipsilateral parotid marked swelling parotid external opening (stenonova) flushing duct and around it.

In lesions submaxillary (submaksillit) and sublingual glands also marked their swelling and soreness. The onset of disease may be affected in isolation any salivary gland, and then affects the salivary glands or other process simultaneously involved in a variety of salivary glands.

Swelling of the affected glands kept 5-7 days, sometimes longer, but it can be very fast inverse dynamics. Suppuration of the glands was observed. Much less develop orchitis, epididymitis, oophoritis, mastitis, Bartolini, prostatitis, and pancreatitis.

Sex glands are affected more often in adults and older children (puberty). Orchitis when there is pain in the testicles, which may radiate to the groin, sometimes pain along the spermatic cord. Testicle increases in size, becomes dense, painful, swollen scrotum.

Orchitis can develop both alone and in conjunction with the defeat of the salivary glands.

Pancreatitis usually been mild and subclinical form. In severe cases, accompanied by severe abdominal pain, repeated vomiting, constipation (sometimes defecation are liquid), reduced appetite.

CNS disease usually manifests serous meningitis, in more severe cases of meningoencephalitis. Since the pig was observed early viremia, changes may be made and other organs and systems (cardiovascular, urinary).

Blood is often detected leukopenia and lymphocytosis (in some cases in the first days of illness may be leukocytosis), erythrocyte sedimentation rate is moderately increased or normal.

For mumps infections are often undulating with repeated temperature rise associated with consistent involvement in the process of glandular organs or the central nervous system.

Subclinical form of the disease is characterized by mild at normal body temperature. Swelling of one or both of the parotid or submandibular glands minor and quickly disappear.

Asymptomatic form is diagnosed only by serological studies.

Infants and children of the first year of life rarely get sick pig. If a woman carries the disease a week before delivery, the baby is born with clinical signs of the disease, or they develop in the postnatal period. The disease is not hard, usually in the form of mumps or submaksillita.

Other glands and central nervous system, the process is not involved.

There are some references to miscarriage and birth of children with developmental disabilities from women who at the beginning of pregnancy suffered the disease, but no convincing evidence of a link between a history of pregnant mumps and congenital malformations no fruit.

In adults, the disease is usually more severe than in children, more pronounced intoxication, prolonged febrile period, often there are complications and affects the sexual glands. Less often than in children, affected the central nervous system.

Orchitis, pancreatitis, aseptic meningitis, or combinations thereof can sometimes occur without prior increase of the salivary glands, in connection with which there are difficulties in diagnosis. In these cases, great importance is attached carefully collected epidemiological history, and according to laboratory tests.

Most dangerous is the outbreak of mumps occurring among recruits in the barracks, dormitories among adolescents and children of high school age.

Complications are rare and mostly in patients with CNS disease. After encephalitis, meningoencephalitis may occur paresis, paralysis and loss of the inner ear, resulting in deafness. Cases of optic nerve atrophy.

Description

Pathogen - RNA virus belonging to the family of paramyxoviruses. Sensitive to heat, drying, disinfectants, but resistant to low temperature.

To chemotherapeutic drugs is not sensitive.

Can be detected in the saliva in the first 2 days of illness in the urine - up to the 14th day from the beginning of the disease, Cerebrospinal fluid - in the first 6 days after onset of clinical symptoms of CNS.

Infection Source of agent - the person who becomes infectious already in the last days of the incubation period, and especially during the first 3-4 days of illness. Duration of infectious period - up to the disappearance of clinical symptoms, but not less than 9 days from onset. Of great importance in the spread of infection are patients with erased and asymptomatic forms.

It is assumed, and of virus. From the body of the patient infectious agent is released with saliva. Infection occurs by droplets from direct contact with the patient. Transmission of pathogens through a third party, and items that were in use the patient has not been proved. Susceptibility to mumps is 30-50%.

The disease occurs at any age, but is most susceptible to his children of preschool and early school age. Children under the age of 1 year, rarely get sick. Mumps is observed in the form of sporadic cases, outbreaks in institutions, and sometimes adult teams.

Marked seasonal incidence, the highest it rises occur in the winter and autumn months.

After this illness produced strong immunity. Cases of recurrent disease are very rare. Passive immunity (obtained from the mother) provides immunity to mumps during the first 6 months of life.

Diagnostics

The diagnosis in typical cases, especially beginning with the defeat of the parotid glands, is not difficult. They occur at a primary lesion or isolated pancreatic, sublingual and other glands in isolated CNS lesions. In these cases it is especially important to take into account the data of epidemiological history.

From laboratory methods for diagnosis of mumps infection in practice using complement binding reactions and inhibition of hemagglutination reaction in paired sera. Great diagnostic significance increase in antibody titer in the dynamics of the disease. As an antigen in the complement binding reaction using standard diagnostic kit.

Treatment

Patients with mild and moderately severe disease are treated at home. Compulsory hospitalization subject to children with severe disease and all patients with lesions of the central nervous system, pancreatitis and orchitis.

Etiotrop specific treatment has not been developed. Assign symptomatic agents. In the acute phase of the disease requires bed rest. It is recommended to drink plenty of liquids, liquid or semi-liquid food gentle.

It is to rinse the mouth after eating boiled water or 2% sodium bicarbonate solution.

In lesions salivary glands shows dry heat (heater or blue light) to the affected region, with a significant increase in body temperature - antipyretic.

Pancreatitis lactic prescribed diet limit fats and proteins, with frequent vomiting shown intravenous drip isotonic sodium chloride solution kontrikalom age in doses within pancreatin 5-6 days.

When serous meningitis lumbar puncture is needed not only as a diagnostic, but also as a therapeutic measure (reduction of intracranial pressure) dehydration therapy - IM solution of magnesium sulfate, intravenously 25% glucose solution with ascorbic acid and vitamin IN 1.

In severe cases of serous meningitis and meningoencephalitis prescribed corticosteroids for 6-8 days. In marked increase in intracranial pressure are shown diuretics.

When orchitis prescribed strict bed rest, wearing a jockstrap, a cold in the first 2-3 days, antihistamines, anti-inflammatory drugs. When a pronounced edema of the scrotum and the testicles is increased along with conservative therapy apply surgical treatment - dissection tunica albuginea testes. There is experience in the treatment of orchitis ribonuclease.

Forecast favorable in most cases: there comes a full recovery. However, after serous meningitis and especially meningoencephalitis, often develops tserebrastenicheskom syndrome (hyperexcitability and irritability and fatigue, headache and others.

), And sometimes hypertensive syndrome. Therefore convalescents with CNS mumps etiology subject to medical check-ups by a pediatrician and neurologist. individual observation time.

Immediately after discharge from the hospital recommended home treatment for 2-4 weeks depending on the state. It is advisable to limit the school load and release the child from sports for 6 months, as well as the preventive vaccination at 1 year.

We suffered mumps orchitis may be subsequently testicular atrophy, disorders of spermatogenesis, reduced fertility and sexual function.

prevention

Active immunization with live vaccine of attenuated strain of A-Z performed at the age of 15-18 months. Diseased isolated until the disappearance of clinical symptoms (at least 9 days from the onset of the disease). Preschool children who had contact with a sick pig, do not allow children in the institution of the 11th day from the moment of contact for 21 days. Final disinfection is not carried out.

© Medical Encyclopedia RAMS

A source: http://doctorpiter.ru/diseases/78