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A 14-year-old boy presented with a 4-day history of worsening painful facial swelling and presternal pain. He was afebrile, had bilateral parotid enlargement highly suggestive of mumps, but with diffuse non-erythematous swelling over the upper sternum, exquisitely tender to palpation (figure 1). He had received the measles, mumps and rubella (MMR)vaccine at 1 and 6 years of age. Subsequently, he developed vomiting and epigastric pain, radiological evidence of pancreatitis and …
R-CE, RF and DP contributed equally.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.