Recurrent mumps in children occurs before puberty and is characterized by recurrent swelling of the parotid area.
The etiology and pathology of recurrent mumps in children is not yet known, and a number of scholars have proposed various etiological theories, generally considered to be related to the following factors.
1. congenital developmental abnormalities.
2. Autoimmune abnormalities. The child often has a history of allergic reactions that occur simultaneously with the swelling of the parotid gland. Some patients are accompanied by abnormal immunological indicators. Immune system is immature and immune function is low in childhood, so retrograde infection can easily occur. The child’s immune system can be cured when it matures.
3. Viral infection mumps may be the causative factor. Some children have a history of mumps before the onset of the disease, and during the acute onset of the disease, the mumps virus antibody titer is elevated.
4. Other factors. Some scholars believe that the disease is caused by repeated bacterial retrograde infections.
Diagnosis: Diagnosis is mainly based on clinical manifestations and parotid angiography.
1. Clinical manifestations: most common around the age of 5; repeated swelling of the parotid gland with discomfort, only mild edema, skin can be flushed; squeezing the unilateral or bilateral gland can be seen in the ductal mouth with pus or jelly-like liquid overflow, a few have abscess formation; most last about a week; the resting phase is mostly uncomfortable, examination of parotid secretion is occasionally cloudy; the interval of weeks or months varies, the younger the interval the shorter the interval, the more likely to The younger the age, the shorter the interval and the more likely it is to recur. The younger the age, the shorter the interval and the more likely it is to recur.
2. Routine examination: Parotid gland imaging is routinely performed. Use 40% iodized oil at 0.1ml/year, and give 1.2ml to 12 years old, and take lateral and panoramic films of the parotid gland, and after 30 minutes take evacuation films. Parotid angiography shows a speckled glandular part, i.e. the terminal duct is punctate and dilated, generally around 2mm in diameter; the dominant duct is mostly normal, occasionally mildly dilated.
3. Differential diagnosis: The main difference is with mumps. Mumps has a seasonal epidemic, which occurs in winter and spring, often bilaterally and simultaneously, with episodic-like symptoms before onset and high fever, significant parotid swelling and pain, more pronounced swelling, no obvious abnormalities at the duct mouth or abnormal discharge, and no history of recurrent swelling.
Treatment measures
Recurrent mumps in children is a disorder that has a tendency to heal itself, and most attacks stop after puberty, so conservative treatment is advocated. The principle is to enhance resistance, prevent secondary infection and reduce flare-ups.
1. Maintain oral hygiene and rinse the mouth with a gargle during episodes.
2. Massage the gland daily to promote saliva discharge, and local physiotherapy is also feasible.
In the acute stage, systemic antibiotics are given, and antibiotic solution can be used to flush the parotid ducts to control inflammation as early as possible.
4.Appropriate immunomodulators, such as levomefloquine, 12.5-25mg daily for 3 days a week for 2 weeks, can regulate the immune function of the child. Thymopentin therapy is administered in the interval.
5.Duct perfusion therapy: The treatment of recurrent parotitis in children with intermittent parotid duct perfusion using 40% iodized oil on the affected side has received very good therapeutic effect and has been clinically proven to be a good treatment method. Since iodized oil has a strong bactericidal effect by dilating the duct system, and since iodized oil is a highly viscous liquid with poor mobility and insoluble in water, it is not absorbed and discharged slowly after being injected into the ducts, and can stay in the ducts for a long time to gradually decompose and slowly release iodine ions to play a continuous bactericidal effect.
The catheter infusion therapy can achieve the best mechanical flushing and effective antibacterial effect with the maximum local concentration of drug in the parotid area, which is an effective method to treat recurrent mumps in children.
The chronic phase is caused by a deficiency of vital energy, the evil toxin does not dissipate, the body is weak, the surface guard is not solid, and the external evil is felt. The party ginseng in the raw pulse drink has the effect of benefiting the qi and dispelling wind, nourishing the yuan, strengthening the spleen and relieving dampness, supporting the righteousness and dispelling evil, nourishing the yin and generating fluid; Huang Qi has the effect of supporting the poison and draining pus. It is possible to treat recurrent mumps in pediatric patients by taking raw vein drink and astragalus liquid orally. Some people choose Yu Ping Feng San (raw Astragalus, Xia Gu Cao, Atractylodes Macrocephalae, Thornbush, Fang Feng, Fusarium, Yu Jin, Red Peony, Bayberry, Radix et Rhizoma, Radix Platycodon grandis, Radix et Rhizoma Glycyrrhizae). One dose was taken daily with water decoction for 20 days as a course of treatment, and the herbal medicine Hibiscus cream was applied externally to achieve better results.
Prognosis evaluation
Recurrent mumps in children has a tendency to heal on its own and usually stops after puberty. However, some patients with recurrent mumps become adults with untreated mumps.