Which of the following childhood infections may cause infertility in the male?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Child Health Nursing (Pediatrics)

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Mumps, a viral infection, can lead to orchitis (inflammation of the testicles) as a complication, particularly in males who have gone through puberty.
This inflammation can damage the seminiferous tubules, which are responsible for sperm production, potentially leading to testicular atrophy and subsequent subfertility or infertility.
Orchitis occurs in up to 30-40% of post-pubertal males infected with mumps.
While other listed infections have serious complications, they do not typically cause male infertility.

Option B: Measles is a viral respiratory infection whose major complications include pneumonia, encephalitis, and subacute sclerosing panencephalitis (SSPE); it does not cause orchitis or infertility.
Option C: Pertussis (whooping cough) is a bacterial respiratory infection. Its complications are primarily respiratory (pneumonia, apnea) and neurological (seizures, encephalopathy) due to hypoxia, not reproductive.
Option D: Diphtheria is a bacterial infection that produces a toxin leading to complications like myocarditis (heart inflammation) and neuritis (nerve damage), but it does not affect the male reproductive system.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Complications of childhood viral infections, specifically mumps-related infertility as background academic context rather than a clinical decision trigger.
Nurses play a key role in educating parents about the importance of the MMR (Measles, Mumps, Rubella) vaccine, which is the most effective way to prevent mumps and its complications like infertility.
During an active mumps infection in an adolescent or adult male, a nurse must assess for testicular pain, swelling, and tenderness, and provide comfort measures like scrotal support and cold compresses.
What if? If the patient was a pre-pubertal male, mumps-induced orchitis is extremely rare and much less likely to result in long-term infertility, although it can still occur.

How to Approach the Question

First, identify the core question: which of the listed childhood diseases can cause male infertility?
Recall the common characteristics and major complications of each listed infection: Mumps, Measles, Pertussis, and Diphtheria.
Focus on the reproductive system. Mumps is famously associated with parotitis (swollen glands) but also has a well-known complication of orchitis (testicular inflammation) in post-pubertal males.
Evaluate the other options. Measles complications are primarily respiratory and neurological. Pertussis and Diphtheria are bacterial infections with respiratory, neurological, and cardiac complications, but not reproductive.
Conclude that Mumps is the only infection on the list with a direct link to male infertility.

Concept Tested & Keywords

Concept Tested: Complications of childhood viral infections, specifically mumps-related infertility.
Stem keywords: childhood infections, infertility, male
Lead-in keywords: Which
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

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E6 Medicine Harrison 22e Part 1 p. 1689-1691

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1975-1977