PAROTITIS WITH ORCHITIS IN ACUTE HCV- A RARE ASSOCIATION

Case report:A male of fourteen years, having non-significant past history, was detected to be sufferingfrom acute hepatitis C virus (HCV) infection, presented with acuteonset of gradually progressive bilateral painful enlargement of parotid glands which was followed by bilateral painful orchitis. His HCV RNA quantitative load was 765421 I.U./ml with hyperbilirubinemia and transaminitis.The ultrasound abdomen revealed mild hepatomegaly with gall bladder wall oedema suggestive of acute hepatitis. He had no evidence of cirrhosis as evidenced by normal Fibroscan score of 6.5. At the time of first consultation, his mental status was normal without any fever but was having mild nausea and generalized weakness. His bilateral parotid glands were enlarged and painful for last one week. He also developed bilateral painful orchitis after five days of developing parotitis. He was started on antiviral treatment for hepatitis C for total of 12 weeks duration but his bilateral parotitis and orchitis subsided within three weeks of starting of treatment. He completed his 12 weeks antiviral treatment and later on achieved 12 weeks sustained virological response (SVR), as evidenced by complete absence of HCV RNA on polymerase chain testing (PCR) report. He has been followed for one and half year and repeat HCV RNA test and clinical examination for relapse is non-contributory.

Conclusion:Our case reportis an uncommon extrahepatic manifestation of acute HCV case of bilateral parotitis in an acute hepatitis C patient. There is paucity of data regardingparotitis and orchitis with acute hepatitis C infection, hence merits vigil for the same by the treating health care specialist.