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Micro - MMR (ii) (Mumps (Complications (CNS involvement (15%) (mumps…

- - - - parotiditis
        
        swelling over angle of mandible
        
        possibly inflamm of other salivary glands
        
        in 30-40%
        
        bilat or unilat
      - orchitis (20-50% of post pubertal males)
  - - - mumps meningitis (viral meningitis rarely causes death/long-term complications)
  - - - serology on oral fluid (acute IgM or 4-fold rise)
      - PCR on throat swabs, urine, oral fluid, CSF
      - culture on oral fluid, throat swabs, urine, CSF (not routine)
- - - - only confirmed teratogenic virus
      - placenta + foetus become infected in viraemic phase
        
        leads to cell destruction + mitosis arrest - congenital abnormalities
    - - similar to measles (same distribution from hairline) but fainter, doesn't become confluent or non-blanching
  - - - PCR on resp secretions, oral fluid, urine, blood
      - serology on blood or oral fluid (acute IgM or 4-fold rise)
      - culture on resp secretions, oral fluid, urine
  - - - spontaneous abortion
      - premature delivery
      - foetal death
      - deafness
        
        may be late onset
        
        usually bilat + sensorineural
        
        2/3 have it longterm
      - blindness
      - cataracts
      - heart defects
      - microcephaly
      - intellectual disability
      - bone abnormalities
      - liver + spleen damage
      - rare in countries where MMR vaccine is routine
      - severity depends on how far along mam was when she was infected
        
        most severe if in 1st trimester (organogenesis)
        
        no documented risk after 20 wks
    - - esp in female adults (rare in males or children)
      - esp in weight-bearing joints (e.g. the knee)
      - usually lasts 1 month (rarely becomes chronic
    - - due to thrombocytopenia/vasc damage