Mumps

===Complications===
Outside of the salivary glands, inflammation of the [[testes]], called [[orchitis]], is the most common symptom infection. Pain, swelling, and warmness of a testis appear usually 1–2 weeks<ref name=masarani >{{cite journal |vauthors=Masarani M, Wazait H, Dinneen M |date=November 2006 |title=Mumps orchitis |journal=J R Soc Med |volume=99 |issue=11 |pages=573–575 |doi=10.1177/014107680609901116 |pmc=1633545 |pmid=17082302 }}</ref> after the onset of parotitis but can occur up to six weeks later. During mumps orchitis, the scrotum is tender and inflamed. It occurs in 10–40% of pubertal and post-pubertal males who contract mumps. Usually, mumps orchitis affects only one testis but in 10–30%<ref name=masarani /> of cases both are affected. Mumps orchitis is accompanied by inflammation of the [[epididymis]], called [[epididymitis]], about 85% of the time, typically occurring before orchitis. The onset of mumps orchitis is associated with a high-grade fever, vomiting, headache, and malaise.<ref name=rubin /><ref name=davis /> In prepubertal males, orchitis is rare as symptoms are usually restricted to parotitis.<ref name=davis />

A variety of other inflammatory conditions may also occur as a result of mumps virus infection, including:<ref name=rubin />
* [[Mastitis]], inflammation of the breasts, in up to about 30% of post-pubertal women<ref name=shu >{{cite journal |vauthors=Shu M, Zhang YQ, Li Z, Liu GJ, Wan C, Wen Y |date=18 April 2015 |title=Chinese medicinal herbs for mumps |journal=Cochrane Database Syst Rev |volume=2015 |issue=4 |pages=CD008578 |doi=10.1002/14651858.CD008578.pub3 |pmc=7198052 |pmid=25887348 }}</ref>
* [[Oophoritis]], inflammation of an ovary, in 5–10% of post-pubertal women, which usually presents as pelvic pain
* Aseptic [[meningitis]], inflammation of the meninges, in 5–10% of cases<ref name=latner >{{cite journal |vauthors=Latner DR, Hickman CJ |date=7 May 2015 |title=Remembering mumps |journal=PLOS Pathog |volume=11 |issue=5 |pages=e1004791 |doi=10.1371/journal.ppat.1004791 |pmc=4423963 |pmid=25951183 |doi-access=free }}</ref> and 4–6% of those with parotitis, typically occurring 4–10 days after the onset of symptoms. Mumps meningitis can also occur up to one week before parotitis as well as in the absence of parotitis. It is commonly accompanied by fever, headache, vomiting, and neck stiffness.<ref name=junghanss >{{cite book |author=Junghanss T |title=Manson's tropical diseases |date=2013 |publisher=Elsevier/Saunders |location=Oxford |isbn=978-0-7020-5306-1 |page=261 |edition=23rd |url=https://books.google.com/books?id=GTjRAQAAQBAJ&pg=PA261 |url-status=live |access-date=30 October 2020 |archive-url=https://web.archive.org/web/20160513194608/https://books.google.com/books?id=GTjRAQAAQBAJ&pg=PA261 |archive-date=13 May 2016}}</ref>
* [[Pancreatitis]], inflammation of the pancreas, in about 4% of cases, which causes severe pain and tenderness in the upper abdomen below the ribs
* [[Encephalitis]], inflammation of the brain, in less than 0.5% of cases.<ref name=latner /> People who experience mumps encephalitis typically experience a fever, altered consciousness, seizures, and weakness. Like meningitis, mumps encephalitis can occur in the absence of parotitis.<ref name=junghanss />
* [[Meningoencephalitis]], inflammation of the brain and its surrounding membranes. Mumps meningoencephalitis is commonly accompanied by fever 97% of the time, vomiting 94% of the time, and headache 88.8% of the time.<ref name=kanra >{{cite journal |vauthors=Kanra G, Isik P, Kara A, Cengiz AB, Seçmeer G, Ceyhan M |date=December 2004 |title=Complementary findings in clinical and epidemiologic features of mumps and mumps meningoencephalitis in children without mumps vaccination |journal=Pediatr Int |volume=46 |issue=6 |pages=663–668 |doi=10.1111/j.1442-200x.2004.01968.x |pmid=15660864|s2cid=43534364 }}</ref>
* [[Nephritis]], inflammation of the kidneys, which is rare because kidney involvement in mumps is usually benign but leads to [[Viruria|presence of the virus in urine]]
* Inflammation of the joints ([[arthritis]]), which may affect at least five joints ([[polyarthritis]]),<ref name=senanayake >{{cite journal |vauthors=Senanayake SN |date=20 October 2008 |title=Mumps: a resurgent disease with protean manifestations |url=https://www.mja.com.au/journal/2008/189/8/mumps-resurgent-disease-protean-manifestations |journal=Med J Aust |volume=189 |issue=8 |pages=456–459 |doi=10.5694/j.1326-5377.2008.tb02121.x |pmid=18928441 |s2cid=13771290 |access-date=30 October 2020}}</ref> multiple nerves in the peripheral nervous system ([[polyneuritis]]), [[pneumonia]],<ref name=davison /> gallbladder without gallstones (acalculous cholecystitis), cornea and uveal tract (keratouveitis), thyroids ([[thyroiditis]]), liver ([[hepatitis]]), retina ([[retinitis]]), and [[corneal endothelium]] (corneal endothelitis), all of which are rare<ref name=rubin /><ref name=shu />
* Recurrent [[sialadenitis]], inflammation of the salivary glands, which is frequent<ref name=davison />

A relatively common complication is [[deafness]], which occurs in about 4% of cases.<ref name=who /> Mumps deafness is often accompanied by vestibular symptoms such as [[vertigo]] and [[Nystagmus|repetitive, uncontrolled eye movements]]. Based on electrocardiographic abnormalities in the infected, MuV also likely infects cardiac tissue, but this is usually asymptomatic. Rarely, [[myocarditis]] and [[pericarditis]] can occur. Fluid buildup in the brain, called [[hydrocephalus]], has also been observed.<ref name=rubin /><ref name=junghanss /> In the first trimester of pregnancy, mumps may increase the risk of miscarriage. Otherwise, mumps is not associated with birth defects.<ref name=gupta /><ref name=shu />

Other rare complications of infection include: paralysis, seizures, cranial nerve palsies, [[cerebellar ataxia]], [[transverse myelitis]], [[ascending polyradiculitis]], a [[polio]]-like disease, [[arthropathy]], [[autoimmune hemolytic anemia]],<ref name=rubin /> [[idiopathic thrombocytopenic purpura]], [[Guillain–Barré syndrome]], post-infectious encephalitis<ref name=shu /> [[encephalomyelitis]],<ref name=senanayake /> and [[hemophagocytic syndrome]].<ref name=davis /> At least one complication occurs in combination with the standard mumps symptoms in up to 42% of cases.<ref name=davis /> Mumps has also been connected to the onset of [[type&nbsp;1 diabetes]], and, relatedly, the mumps virus is able to infect and replicate in [[insulin]]-producing [[beta cell]]s.<ref name=smatti >{{cite journal |vauthors=Smatti MK, Cyprian FS, Nasrallah GK, Al-Thani AA, Almishal RO, Yassine HM |date=19 August 2019 |title=Viruses and Autoimmunity: A Review on the Potential Interaction and Molecular Mechanisms |journal=Viruses |volume=11 |issue=8 |pages=762 |doi=10.3390/v11080762 |pmc=6723519 |pmid=31430946 |doi-access=free }}</ref> Among children, seizures occur in about 20–30% of cases involving the central nervous system.<ref name=gupta />
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