Case Report: Periorbital Edema as an Overlooked Presentation of Epstein-Barr Virus.

ABSTRACT:

Introduction

Infectious mononucleosis (IM), most commonly caused by Epstein-Barr virus (EBV), classically presents with fever, pharyngitis, and cervical lymphadenopathy. However, less common manifestations such as bilateral periorbital edema, known as Hoagland sign, may precede or obscure more typical features, complicating diagnosis. Although described in the literature for decades, Hoagland sign remains underrecognized in clinical practice, especially in pediatric and young adult patients. This oversight can lead to misdiagnosis, delayed testing, unnecessary antibiotic use, and patient distress.

Case presentation

We present 2 cases of female patients, one pediatric and one young adult, who initially presented with bilateral periorbital edema and nonspecific systemic sympto

SUBMITTER: Ohri S 

PROVIDER: S-EPMC12659628 | biostudies-literature | 2025 Jan-Dec

REPOSITORIES: biostudies-literature