Clinical features of mumps orchitis:
(1) It usually occurs in postpubertal males who have not been vaccinated. It is rare in males younger than 10 years of age.
(2) Other manifestations of mumps (parotitis, fever, chills, etc.) are usually present.
(3) It is bilateral in about 16% of patients with testicular involvement
(4) The testis is warm and may swell to 4 times its normal size.
(5) The testis may be painful and extremely tender.
Laboratory findings:
(1) Serology (usually ELISA) shows seroconversion with IgM anti-mumps antibodies or a four-fold rise in titer.
(2) The virus can be cultured from the saliva a few days before and for 4-5 days after onset.
Complications:
(1) persistent tenderness
(2) atrophy
(3) cosmetic imbalance
(4) anxiety about infertility
(5) rarely infertility
(6) very rarely testicular neoplasia in an atrophic testis
The development of antisperm antibodies is controversial.
Differential diagnosis:
(1) acute torsion
(2) bacterial epididymo-orchitis
(3) orchitis due to Coxsackie or other viruses
(4) orchitis following mumps immunization
