A 16-year-old previously well girl presented with a fever for two or three days and with a left-sided facial swelling that had arisen within the previous 24 hours. She denied any dental problems. On examination, she had an obvious large tender swelling of the left side of her face. She was generally unwell.
She had received MMR vaccination at 13 months and then at age six had been vaccinated with MR in the catch-up programme.
What is the diagnosis, management and differential diagnosis?
Diagnosis and management
The diagnosis is mumps (acute parotitis). Mumps causes fever, headache, malaise, dry mouth and difficulty swallowing. It may also cause orchitis in older males and rarely pancreatitis or encephalitis.
There is no specific treatment and the symptoms resolve spontaneously, with analgesia, fluids and mouth washes.
Possible different diagnoses
- Cervical lymph node enlargement.
- Dental infections/abscess.
- Strictures/calculi in the parotid duct.
- Localised pain.
- Sensitivity to changes in temperature and air.
- Antibiotics are useful before dental intervention.
- Refer to dentist.