› Analgesia and antipyretics
› Acetaminophen for fever and pain
› Adults: 500-1000 mg orally every 4-6 hours as needed
› Maximum 4000 mg per 24 hours in healthy adults
› Reduce dose in hepatic impairment
› Ibuprofen for pain and inflammation
› Adults: 400-600 mg orally every 6-8 hours with food
› Preferred for orchitis-related pain and inflammation
› Avoid in renal impairment and gastrointestinal ulcer disease
› Avoid aspirin in children
› Reye syndrome risk in viral illness
› Local measures for parotitis
› Warm or cold compresses to parotid glands
› Patient preference guides choice
› Dietary modifications
› Soft bland diet during acute parotitis
› Avoid sour or acidic foods that stimulate salivary flow
› Adequate hydration essential
› Conservative management of orchitis
› Bed rest and scrotal elevation
› Scrotal support or elevation on towel roll
› Ice packs to scrotum
› Applied intermittently to reduce swelling
› NSAIDs as first-line anti-inflammatory therapy
› Ibuprofen 400-600 mg orally every 6-8 hours
› Corticosteroids for severe orchitis
› Limited evidence for benefit
› May reduce pain and duration in severe cases
› No proven benefit for fertility outcomes
› Prednisolone 1 mg/kg/day orally if considered
› Typically 5-7 day course
› Consult urology before initiating
Meningitis and encephalitis management
› Supportive management for viral meningitis
› IV hydration and analgesia
› Mumps meningitis typically self-limited
› Resolution expected within 7-10 days
› Antiemetics for nausea and vomiting
› Ondansetron 4-8 mg IV or orally every 8 hours
› Serial neurological assessments
› Escalate to ICU for declining GCS or seizures
› Encephalitis management
› Antiepileptic therapy for seizures
› Levetiracetam 500-1500 mg IV loading dose
› Benzodiazepine for active seizure termination
› Lorazepam 0.1 mg/kg IV for status epilepticus
› Exclude HSV encephalitis
› Empiric acyclovir 10 mg/kg IV every 8 hours pending HSV PCR
› Discontinue if HSV PCR negative and clinical course consistent with mumps
› Fluid resuscitation
› IV lactated Ringer's preferred over normal saline
› 250-500 mL/hour for first 12-24 hours
› Target urine output 0.5-1.0 mL/kg/hour
› NPO during acute phase
› Resume oral feeding when pain improves and nausea resolves
› Early enteral feeding preferred over prolonged NPO
› Pain management for pancreatitis
› IV opioid analgesia for severe pain
› Morphine 2-4 mg IV every 4-6 hours as needed
› Hydromorphone 0.2-0.4 mg IV every 4-6 hours as alternative
› Serial lipase monitoring
› Trending toward normal with clinical improvement expected
› No specific antiviral treatment for mumps
› No approved antiviral agents with proven efficacy
› Treatment entirely supportive
› Intravenous immunoglobulin not indicated
› Antibiotics not indicated for uncomplicated viral parotitis
› Reserve antibiotics for confirmed bacterial sialadenitis
Outbreak and public health interventions
› MMR vaccination for outbreak control
› Third dose of MMR during outbreak
› ACIP recommends a third dose for persons at increased risk during an outbreak
› MMWR 2018 guidance supports this approach
› Post-exposure prophylaxis
› MMR vaccine may provide some protection if given promptly after exposure
› Unvaccinated contacts should receive MMR regardless of exposure timing
Show 48 more ▾