Muralitharan Jyotsnaa, Nagarajan Vijayakumar, Ravichandran Umarani
Internal Medicine, Rajah Muthiah Medical College & Hospital, Chidambaram, IND.
Cureus. 2022 Dec 31;14(12):e33195. doi: 10.7759/cureus.33195. eCollection 2022 Dec.
Mumps is an acute viral illness occurring in children and young adults transmitted via droplets. It is a vaccine-preventable illness caused by the mumps virus, an RNA (ribonucleic acid) virus belonging to theParamyxoviridaefamily. It typically presents with fever, parotitis, epididymo-orchitis, oophoritis, meningitis, encephalitis, pancreatitis and arthritis. Although viremia with multiorgan involvement is known to be commonly seen in mumps, there have been no reported cases of splenic abscess in a case of mumps. Here we present the case of a 16-year-old girl with unknown vaccination history who presented with fever, rash, bilateral parotid swelling, myocarditis, pneumonitis with pleural effusion and shock. Enzyme-linked immunosorbent assay (ELISA) for mumps Immunoglobulin M (IgM) antibody was positive (ratio: 7.26, reference: 1.10). She was managed conservatively with parenteral antibiotics, oxygen, inotropic support and bronchodilators. As she complained of abdominal pain in the left hypochondrium on the 13th day since onset of symptoms, ultrasound scan of abdomen was done which showed a hypoechoic lesion with internal echoes in the inferior pole of spleen (2.9 cm x 2.2 cm) suggestive of splenic abscess. Computed tomography (CT) of abdomen confirmed similar findings. The splenic abscess completely regressed with parenteral antibiotics. Therefore, one must suspect splenic abscess in a case of mumps when the presentation includes abdominal pain and tenderness so that appropriate treatment may be provided for the best outcome for the patient.
腮腺炎是一种发生于儿童和青年的急性病毒性疾病，通过飞沫传播。它是一种可通过疫苗预防的疾病，由腮腺炎病毒引起，腮腺炎病毒是一种属于副粘病毒科的RNA（核糖核酸）病毒。其典型表现为发热、腮腺炎、附睾炎-睾丸炎、卵巢炎、脑膜炎、脑炎、胰腺炎和关节炎。虽然已知腮腺炎常见病毒血症伴多器官受累，但尚无腮腺炎患者出现脾脓肿的报道。在此，我们报告一例16岁女孩，其疫苗接种史不明，出现发热、皮疹、双侧腮腺肿大、心肌炎、伴有胸腔积液的肺炎和休克。腮腺炎免疫球蛋白M（IgM）抗体的酶联免疫吸附测定（ELISA）呈阳性（比值：7.26，参考值：1.10）。她接受了肠外抗生素、氧气、强心支持和支气管扩张剂的保守治疗。由于她在症状出现后的第13天诉说左季肋部腹痛，遂进行腹部超声检查，结果显示脾脏下极有一个低回声病变，内部有回声（2.9厘米×2.2厘米），提示脾脓肿。腹部计算机断层扫描（CT）证实了类似的发现。经肠外抗生素治疗后，脾脓肿完全消退。因此，对于出现腹痛和压痛的腮腺炎患者，必须怀疑脾脓肿，以便为患者提供适当治疗，取得最佳治疗效果。
