A patient with infectious mononucleosis may present with periorbital and eyelid edema, a finding known as Hoagland's sign.


Clinical features of Hoagland's sign:

(1) The patient develops periorbital and eyelid edema.

(2) The onset is several days prior to the onset of other clinical findings.

(3) The patient later shows serologic evidence of EBV infection.

(4) Other causes (contact allergy, cellulitis, etc) are excluded.


Ultrasound will show evidence of dacryoadenitis (inflammation of the lacrimal gland).


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