Mumps misdiagnosed as adnexitis

Tingting is a primary school Chinese teacher. She went to the hospital for treatment due to lower abdominal pain for 2 days. There was no fever, chills, urgency, frequent urination and dysuria, and no history of amenorrhea. After admission, the physical examination: body temperature 36.7℃, respiration 20 times/min, pulse 82 times/min, general condition, clear mind and speech, painful expression, no poisoning, no yellowing of the skin and sclera, no enlargement of superficial lymph nodes, no congestion of the pharynx, flat and soft abdomen, tenderness, no rebound pain and muscle tension; gynecological examination: vulva married type, vaginal smoothness, not much secretion, II degree cervical erosion; leucorrhea routine: cleanliness II degree, no trichomonas, mold; blood routine: white blood cells 10.2×109/L, neutrophils 73%, lymphocytes 28%, hemoglobin 121g/L; urine routine and biochemistry normal; B-ultrasound examination: uterus retroverted, normal size, bilateral appendages thickening, more obvious on the left. Diagnosed as acute adnexitis and chronic cervicitis. Cefoperazone and metronidazole were given intravenous drip, but the abdominal pain was not relieved significantly. The next day, bilateral earlobes were swollen, itchy, tender, with unclear boundaries, and congestion of the parotid duct opening. After asking about the medical history, it was found that there was a patient with mumps among the students he taught. Interferon 1 million U was injected intramuscularly and ribavirin was taken orally for 3 days, and the abdominal pain was relieved and the swelling of the parotid gland disappeared. .

Mumps is common in preschool and school-age children and is highly contagious, but rarely seen in adults. Mumps can be complicated by encephalitis, pancreatitis, orchitis, adnexitis (oophoritis), etc. The incidence of oophoritis is very low, especially after puberty, and the symptoms are atypical and difficult to diagnose. This case is a woman of childbearing age with abdominal pain symptoms. Most people consider gynecological or medical diseases, but ignore the prevalence of infectious diseases in her living environment, resulting in misdiagnosis.