title: [Bilateral lid swelling during infectious mononucleosis (Hoagland-sign)].
abstract: BACKGROUND
  Infectious mononucleosis ("kissing disease") is an infection caused by Epstein-Barr-Virus (EBV, human herpes virus 4).
  
  
  METHODS
  We present the case of an 18-year old female patient with dacryoadenitis and sub-febrile temperatures followed by a distinct feeling of sickness.
  
  
  RESULTS
  Laboratory results revealed a Leukocytosis of 16.3 G/I with explicit elevation of hepatic parameters. The ultrasound scan of the orbital region showed a bilateral, echo-reduced, compressible lesion in the area of the lachrymal gland. The abdomen-ultrasound scan revealed a splenomegaly and the size of the liver was within normal limits. Serology was positive for EBV-VCA-IgG, EBV-EA-IgG and EBV-VCA-IgM.
  
  
  CONCLUSIONS
  A dacryoadenitis can be the presenting symptom of an infectious mononucleosis.
authors.affiliation: Augenklinik der Ludwig-Maximilians-Universität, München. johannes.burger@med.uni-muenchen.de
authors.forename: J
authors.initials: J
authors.lastname: Burger
authors.forename: S
authors.initials: S
authors.lastname: Thurau
authors.forename: C
authors.initials: C
authors.lastname: Haritoglou
mesh_terms: D000293:Adolescent; D003607:Dacryocystitis / Q000175:diagnosis* / Q000209:etiology*; D005141:Eyelid Diseases / Q000175:diagnosis* / Q000209:etiology*; D005335:Fever of Unknown Origin / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007244:Infectious Mononucleosis / Q000150:complications* / Q000175:diagnosis*