Mumps encephalitis in an immunocompromised adult

Mumps encephalitis became a rare complication of mumps virus infection after the vaccination era. However, in immunosuppressed individuals and those with incomplete vaccination history, the virus remains an important differential in cases of infective encephalitis. We present the case of an adult male with Crohn’s disease on immunosuppression who developed acute encephalopathy with seizure, abnormal neuroimaging findings, with no initial signs of parotitis. The diagnosis of mumps meningoencephalitis was delayed by subtle, emerging clinical manifestations and incomplete vaccination history. This case provides learning opportunities relating to the clinical timeline of mumps encephalitis, the value of subtle changes in the diagnostic imaging, and important considerations relating to mumps serological investigation.