Differential diagnosis 1. testicular torsion Sudden enlargement of the scrotum and pain with obvious tenderness without a history of mumps, pain not reduced but increased by holding up the scrotum; no fever; reduced or absent testicular blood perfusion as seen by color Doppler ultrasound. 2. Acute epididymitis There may be sudden enlargement of the scrotum and pain with obvious tenderness. However, initially only the epididymis is swollen and the testis may be normal or slightly hard; when the inflammation of the epididymis spreads to the testis, the boundary between the testis and the epididymis is unclear and both have tenderness. 3.Acute purulent orchitis may also manifest as sudden scrotal pain and enlargement, but without a history of mumps, usually the testicles and epididymis are enlarged and the boundaries are unclear, and antibiotic treatment is effective. 4.Inserted hiatal hernia may also present with sudden scrotal pain and enlargement. With a previous history of inguinal hernia, abdominal distention and vomiting may occur after impaction. Physical examination may reveal a scrotal mass and a normal testicle. Complications Mumps-induced orchitis results in irreversible destruction of sperm in approximately 30% of patients. The affected testes are highly atrophic. In the case of bilateral orchitis, it leads to male infertility, but androgen levels are generally normal. Treatment 1. Antibiotics are not effective for this disease and symptomatic treatment is the mainstay. Bed news, local cold or hot compresses, raising the testicles to reduce discomfort, painkillers and antipyretics can be used according to the situation. 2, the use of adrenal corticosteroids, injection of serum in patients recovering from the disease has clear efficacy. 3.Lidocaine low level spermatic cord closure to improve testicular blood flow and protect spermatogenic function. 4, interferon has better efficacy in acute mumps and viral orchitis. In addition, interferon through antiviral activity and immunomodulatory effect to inhibit viral replication and improve immune function, to alpha-2b interferon treatment of mumps combined with orchitis effective and can prevent future testicular atrophy or infertility.