Mumpsorchitis

Mumpsorchitis refers to orchitis caused by the mumps virus, a complication of mumps infection. It most often occurs in postpubertal males and typically develops several days after the onset of parotitis, though parotid swelling may be concurrent.

Transmission occurs via respiratory droplets, and vaccination with the MMR vaccine substantially reduces risk. In unvaccinated individuals, orchitis occurs in roughly 20 to 30 percent of postpubertal men with mumps. It is usually unilateral; bilateral involvement occurs in a minority and is more likely to impact fertility potential.

Clinically, mumps orchitis presents with acute testicular pain and swelling, sometimes associated with fever and malaise. The affected testis is tender and enlarged, and the epididymis may be involved. Doppler ultrasound helps distinguish it from testicular torsion and other causes of acute scrotum and may show enlarged, hyperemic testicular tissue. Laboratory testing can support the diagnosis with mumps-specific serology (IgM) or positive RT-PCR in saliva or urine.

Management is primarily supportive: scrotal elevation or support, analgesia, hydration, and rest. Antibiotics are not routinely indicated unless a concurrent bacterial infection is suspected. Most patients recover fully, but there is a risk of testicular atrophy and possible subfertility, particularly with bilateral involvement. Prevention through vaccination with the MMR vaccine reduces incidence of mumps and, therefore, mumps orchitis.