Related Experiment Video
Updated: Aug 14, 2026

Ultrasonographic Evaluation of Salivary Glands for Sjogren's Syndrome: Diagnostic and Monitoring Insights
Published on: October 13, 2023
[Bilateral lid swelling during infectious mononucleosis (Hoagland-sign)]
J Burger1, S Thurau, C Haritoglou
1Augenklinik der Ludwig-Maximilians-Universität, München. johannes.burger@med.uni-muenchen.de
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.
Related Concept Videos
Bacterial Meningitis
Viral Meningitis
Bacterial Meningitis I: Introduction
Herpes

