The parotid gland is the largest of the salivary glands and is located on both cheeks near the earlobe. The enlarged parotid gland is centered on the earlobe and can be on one or both sides. The cause is infectious, immunologic, obstructive, or unexplained inflammatory enlargement. The most common cause of mumps is infection, mostly bacterial and viral. 1. What types of mumps are there? (1) Purulent parotitis is often unilateral, and bilateral involvement is rare. In the early stages of inflammation, the symptoms are mild or insignificant, with mild pain, enlargement and pressure in the parotid area. The duct opening is mildly red, swollen, and painful. As the disease progresses, fever, chills and unilateral parotid pain and swelling may occur. Localized redness, swelling, heat and pain of the parotid gland and surface skin. When the lesion enters the suppurative stage, squeezing the parotid gland reveals pus flowing from the ductal opening. (2) Mumps Viral mumps is most commonly known as mumps. Mumps is a contagious disease, the source of infection is the patient and the latent infected person, and transmission is through respiratory droplets and close contact. The clinical onset is rapid, often with prodromal symptoms such as fever, headache, and poor appetite. The swelling is usually centered on the earlobe and develops forward, backward and downward, with indistinct margins and mild tenderness, and the pain increases when chewing with the mouth open and eating an acidic diet. The submandibular or sublingual glands can also be affected, and swelling of the tongue and neck can be seen when the sublingual glands are enlarged, and swallowing difficulties can occur. The mouth of the parotid duct may be red and swollen in the early stages, which helps in the diagnosis. In atypical cases, there may be no swelling of the parotid gland at all, but symptoms of simple orchitis, meningoencephalitis, or swelling of the submandibular or sublingual glands only. In men, if the testes are involved, this may lead to infertility. (3) Autoimmune mumps Most often seen in chronic autoimmune diseases such as dry syndrome, IgG4-related diseases, etc. In addition to recurrent parotid enlargement, there are other glands, joints, organ involvement and injuries. 2. Can mumps cause infertility? Only when the mumps virus, which affects the testes, can lead to infertility. It has been reported that about 30% of post-pubertal mumps patients have combined orchitis, mostly unilateral, with a bilateral incidence of 10%-30%. Irreversible testicular atrophy will occur months to years after infection, leading to non-obstructive azoospermia. The mumps virus can also cause inflammation of the genital ducts leading to blockage of the vas deferens, which can lead to obstructive azoospermia in adulthood. 3. How is mumps diagnosed? (1) Purulent mumps based on clinical manifestations and signs (localized redness, swelling and pain in the parotid gland, pus flowing from the parotid orifice when the parotid gland is squeezed, onset usually unilateral,). The total white blood cell count increases, the proportion of neutrophils increases significantly, and the nucleus shifts to the left. Bacterial culture of pus from the parotid ducts can clarify the diagnosis. (2) Mumps Based on the epidemiological situation and patient contact history, fever, swelling of the parotid gland centered on the earlobe, localized skin fever, tension and shining but not red skin, usually involving the contralateral parotid gland, increasing pain when chewing with the mouth open and eating an acidic diet, may involve other organs such as salivary glands, pancreas, testes or central nervous system. The clinical diagnosis can be made with a normal or reduced white blood cell count (which may be increased in those with orchitis) and an increased blood and urine amylase. The diagnosis can be confirmed by a positive IgM antibody to the specific mumps virus (not vaccinated within 1 month), and a ≥4-fold increase in IgG antibody to the mumps virus in the recovery and acute phases (including a positive shift in antibody). 4.How to treat mumps? (1) Purulent mumps (a) Treat the cause and correct the water, electrolyte and acid-base balance. (b) Select effective antibacterial drugs, empirically apply high-dose penicillin or first- and second-generation cephalosporins and other antibiotics against gram-positive cocci, and take pus from the parotid ducts for bacterial culture and drug sensitivity, and adjust sensitive antibiotics according to drug sensitivity. (c) Other conservative treatment, early inflammation can be used hot compresses, physiotherapy, external compresses and other methods. Sodium bicarbonate solution, mouth rinse such as oral tide can help control inflammation. (d) Conservative medical treatment is ineffective and requires incision and drainage when septicemia develops. (2) Mumps (a) Isolation and bed rest until the swelling of the parotid gland has completely subsided. Pay attention to oral hygiene, avoid acidic food, and ensure fluid intake. (b) Symptomatic treatment is the mainstay, antibiotics are not effective. Ribavirin can be tried. Interferon has been reported to be effective. (c) Adrenocorticotropic hormone therapy is not yet effective, but short-term use can be considered in severe cases or when complicated by meningoencephalitis and myocarditis. (d) He-Ne laser local irradiation for mumps is effective in relieving pain and reducing swelling. (e) Application of hexestrol in male adult patients in the early stages of the disease to prevent the occurrence of orchitis. (f) Chinese herbal medicine: Internal medicine is based on the formula of Puji Disinfection Drink and is added and reduced according to the symptoms. Topical application can be done with Zijin Ingot or Qing Dai San with vinegar, once a day. 5.How to prevent mumps? Mumps is mostly prevalent in winter and spring, so practice good personal hygiene, participate in more exercises to strengthen your body; get vaccinated against measles, rubella and mumps at the right time; pay attention to indoor ventilation, keep the air circulating, and disinfect your home with 0.2% peroxyacetic acid; don’t participate in large group activities during the epidemic period, etc.