A Case of Mumps with Laryngeal Edema

Abstract

A 25 -year-old man who had a history of acute mumps infection at 3 years of age presented with a sore throat and high fever. A local otolaryngologist noticed the severe swelling of his salivary glands and laryngeal edema and the patient was referred to our hospital. A physical examination showed the severe bilateral swelling of the parotid and submandibular glands. Laryngeal fiberscopy indicated an advanced edematous change in the supraglottis. Enhanced computed tomography of the neck revealed swelling of the salivary glands and cervical lymph nodes with no evidence of abscess. Laboratory tests showed a leukocyte count of 6.6×10³/μL（neutrophils 75.8% , lymphocytes 17.8% , and monocytes 5.8%）, a CRP level of 1.56 mg/dL, and a serum Amylase level 992 IU/L. After admission, tracheostomy was performed. The diagnosis of mumps was confirmed by the elevation of mumps-specific immunoglobulin M titers. Laryngeal edema associated with mumps is thought to be caused by lymphatic congestion, secondary to salivary gland enlargement due to inflammation. It is therefore essential to examine the airway by laryngoscopy in mumps patients with swelling of the submandibular and parotid glands.