If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
A 19-year-old female patient presented to the emergency department with a one-week
history of fever, malaise, and progressive eyelid swelling. She had no remarkable
past medical history and seemed at ease during her consultation. A physical examination
showed the following: blood pressure, 139/82 mm Hg; heart rate, 81/min; temperature,
37.9 °C (100.2 °F); respiratory rate, 16/min; and oxygen saturation, 98% on room air.
Marked bilateral periorbital edema (Fig. 1A) and posterior cervical lymphadenopathy were observed. The edema was localized in
the eyelids. No peripheral edema was found, including in the lower extremities. Ultrasound
revealed splenomegaly. A blood test showed an elevated white blood cell count (11,800/μL)
and mild liver dysfunction. A peripheral blood smear showed lymphocytosis with a significant
increase in atypical lymphocytes (17.0% of total lymphocytes). IgM and IgG antibody
titers to Epstein-Barr viral capsid antigen (VCA) were elevated, but IgG antibody
to Epstein-Barr virus nuclear antigen (EBNA) was negative.
Fig. 1A. Arrows show periorbital edema in infectious mononucleosis, also known as Hoagland's
sign. B. Eyelids after recovery.
