Unexplained Bilateral Jaw Swelling in a Vaccinated Adult
I’m reaching out to the medical community for some insights regarding a puzzling health issue. Despite discussing this with various doctors, I am still seeking answers and would appreciate your thoughts. **Case Overview:** - **Patient Info:** A 31-year-old male from Britain, generally in good health. - **Date of Incident:** February 14, 2018. - **Location:** Vancouver, British Columbia, Canada (recent return from the UK). **Symptoms:** Upon waking up, I experienced intense pain on both sides of my jaw, initially dismissing it as just having slept awkwardly. However, within an hour, I noticed significant swelling in my face, particularly around the jaw and parotid gland, which was eerily symmetrical. I did not have a fever, fatigue, or any other systemic symptoms, and there was no discomfort or swelling in the testicular area. My immediate assumption, along with my doctor's, was mumps. However, the findings led us elsewhere. **Diagnostic Results:** - I had received the MMR vaccine as a child in the UK. - Mumps IgG titres were over 98%, indicating strong immunity. - Both Mumps PCR and IgM tests returned negative. - No pus, pain related to meals, or signs of sialolithiasis were observed. **Progression of Condition:** - The pain was excruciating, lasting around 4 to 5 days, manageable only through ice packs. - Antibiotics were not administered. - The swelling completely subsided in about a week. - Since that episode, there has been no recurrence. **Epidemiological Aspect:** Approximately four months following my experience, a close friend, also 31 years old and residing in the UK, presented with an identical situation: severe pain in both jaws and facial swelling, but without fever or systemic illness. Notably, she had not traveled, and our last in-person meeting was a month prior to my episode. Fortunately, she too recovered within roughly a week. Interestingly, no other mutual acquaintances have reported similar symptoms. Neither of us has had anything like this since. **Questions Raised:** What could possibly account for these episodes? Could it be a form of viral parotitis unrelated to mumps—perhaps caused by EBV, CMV, or Coxsackie viruses? Could environmental factors play a role? Is this a case of reactivation or an untested pathogen? Given that we are two healthy adults who experienced the condition bilaterally and had significant contact, the four-month gap continues to baffle me. I am open to any inquiries and would greatly appreciate learning about similar cases, if anyone has encountered them.
Answers (1)
6/25/2025, 9:20:43 AM
OpenHealth AI
Your experience with unexplained bilateral jaw swelling and pain is indeed puzzling, and it’s understandable why you’re seeking more clarity. Let's focus on the key concerns and what might be going on.
Main Points:
You experienced sudden, intense jaw pain with symmetrical swelling, and your tests ruled out mumps despite having strong immunity. This prompts consideration of other viral causes or potential environmental factors.
Explanation:
Bilateral jaw swelling and pain could result from several factors, including viral infections (like those caused by Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV)), which can lead to parotitis. Coxsackie viruses could also be possibilities. Your strong response to the MMR vaccine significantly decreases the likelihood of mumps, especially with negative PCR and IgM tests.
Environmental factors—such as exposure to allergens, irritants, or even a localized infection that didn't present typical systemic symptoms—could also play a role. The coincidence of your friend's similar symptoms raises the possibility of a transmissible cause or even a shared environmental trigger.
Next Steps:
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Monitor Symptoms: Keep an eye on your health. If you notice any recurrence of symptoms, make a note of circumstances that might have preceded them (such as activities, foods, or exposures).
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Consider Further Testing: If similar symptoms arise, discuss with a healthcare provider the possibility of testing for viruses like EBV or CMV, as well as other less common infections.
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Maintain Good Oral Hygiene: This can help prevent potential infections around the jaw and parotid glands.
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Document Experiences: Keep a detailed journal of any related health issues or environmental exposures both you and your friend experienced around the time of your symptoms.
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Consider Environmental Factors: Reflect on any changes in your environment (new products, stress factors, etc.) that may correlate with your episodes.
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Consult Specialists: If this persists or concerns you, seeking out a specialist in infectious diseases or an otolaryngologist could provide additional insights.
Your health is important, and while these occurrences can be mysterious, focusing on monitoring and the above steps could help clarify any underlying issues if they arise again.
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