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Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience

BACKGROUND: The typical presentation of Epstein–Barr virus infectious mononucleosis includes fever, pharyngitis, measles-like rash, jaundice, and enlarged lymph nodes, liver, or spleen. A painless bilateral swelling of the upper eyelid, sometimes with drooping of the lateral aspect, may also occur....

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Autores principales: Bronz, Gabriel, Zanetti, Benedetto P. E. S. M., Bianchetti, Mario G., Milani, Gregorio P., Lava, Sebastiano A. G., Neuhaus, Thomas J., Witschi, Anne, Kottanattu, Lisa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042980/
https://www.ncbi.nlm.nih.gov/pubmed/36224451
http://dx.doi.org/10.1007/s15010-022-01932-6
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author Bronz, Gabriel
Zanetti, Benedetto P. E. S. M.
Bianchetti, Mario G.
Milani, Gregorio P.
Lava, Sebastiano A. G.
Neuhaus, Thomas J.
Witschi, Anne
Kottanattu, Lisa
author_facet Bronz, Gabriel
Zanetti, Benedetto P. E. S. M.
Bianchetti, Mario G.
Milani, Gregorio P.
Lava, Sebastiano A. G.
Neuhaus, Thomas J.
Witschi, Anne
Kottanattu, Lisa
author_sort Bronz, Gabriel
collection PubMed
description BACKGROUND: The typical presentation of Epstein–Barr virus infectious mononucleosis includes fever, pharyngitis, measles-like rash, jaundice, and enlarged lymph nodes, liver, or spleen. A painless bilateral swelling of the upper eyelid, sometimes with drooping of the lateral aspect, may also occur. This sign, referred to as Hoagland sign, is not or only marginally mentioned in reviews and textbooks. METHODS: Between 2019 and 2021, two of us evaluated all subjects with a positive acute Epstein–Barr virus serology for the typical signs of mononucleosis and for the possible existence of the Hoagland sign. RESULTS: During the mentioned period, the diagnosis of mononucleosis was made in 26 (14 females and 12 males) subjects aged from 9.0 to 33 years. The initial presentation included fever in 24, enlarged cervical lymph nodes in 23, pharyngitis in 21, a palpable liver in 7, a palpable spleen in 7, jaundice in 2, and a measles-like rash in 2 cases. The Hoagland sign was noted in 14 cases. Patients with and without Hoagland sign did not significantly differ with respect to age and sex. CONCLUSIONS: The Hoagland sign is an easily identifiable clinical sign that is common and likely helpful early in the course of Epstein–Barr virus infectious mononucleosis. There is a need to expand awareness of this sign among physicians.
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spelling pubmed-100429802023-03-29 Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience Bronz, Gabriel Zanetti, Benedetto P. E. S. M. Bianchetti, Mario G. Milani, Gregorio P. Lava, Sebastiano A. G. Neuhaus, Thomas J. Witschi, Anne Kottanattu, Lisa Infection Brief Report BACKGROUND: The typical presentation of Epstein–Barr virus infectious mononucleosis includes fever, pharyngitis, measles-like rash, jaundice, and enlarged lymph nodes, liver, or spleen. A painless bilateral swelling of the upper eyelid, sometimes with drooping of the lateral aspect, may also occur. This sign, referred to as Hoagland sign, is not or only marginally mentioned in reviews and textbooks. METHODS: Between 2019 and 2021, two of us evaluated all subjects with a positive acute Epstein–Barr virus serology for the typical signs of mononucleosis and for the possible existence of the Hoagland sign. RESULTS: During the mentioned period, the diagnosis of mononucleosis was made in 26 (14 females and 12 males) subjects aged from 9.0 to 33 years. The initial presentation included fever in 24, enlarged cervical lymph nodes in 23, pharyngitis in 21, a palpable liver in 7, a palpable spleen in 7, jaundice in 2, and a measles-like rash in 2 cases. The Hoagland sign was noted in 14 cases. Patients with and without Hoagland sign did not significantly differ with respect to age and sex. CONCLUSIONS: The Hoagland sign is an easily identifiable clinical sign that is common and likely helpful early in the course of Epstein–Barr virus infectious mononucleosis. There is a need to expand awareness of this sign among physicians. Springer Berlin Heidelberg 2022-10-12 2023 /pmc/articles/PMC10042980/ /pubmed/36224451 http://dx.doi.org/10.1007/s15010-022-01932-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Brief Report
Bronz, Gabriel
Zanetti, Benedetto P. E. S. M.
Bianchetti, Mario G.
Milani, Gregorio P.
Lava, Sebastiano A. G.
Neuhaus, Thomas J.
Witschi, Anne
Kottanattu, Lisa
Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title_full Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title_fullStr Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title_full_unstemmed Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title_short Bilateral upper eyelid swelling (Hoagland sign) in Epstein–Barr infectious mononucleosis: prospective experience
title_sort bilateral upper eyelid swelling (hoagland sign) in epstein–barr infectious mononucleosis: prospective experience
topic Brief Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10042980/
https://www.ncbi.nlm.nih.gov/pubmed/36224451
http://dx.doi.org/10.1007/s15010-022-01932-6
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