Presternal Edema in an Adult with Mumps: A Rare Case Highlighting Gelli’s Sign

Case Presentation:

An 18-year-old previously healthy female student presented with a fever and sore throat for 2 days, followed by bilateral painful swelling of the parotid glands. A clinical diagnosis of mumps was made, and the patient was managed conservatively in isolation.

Three days into her illness, her fever subsided, but she developed new, painful swelling in the anterior lower neck. Examination revealed diffuse, non-pitting swelling in the presternal region, obliterating the suprasternal notch and consistent with presternal edema. There were no overlying skin changes, systemic symptoms, or signs of abscess formation.

Given the temporal relationship with parotitis and the classical findings, a diagnosis of presternal lymphedema secondary to mumps was made. The patient continued with conservative management, including observation and supportive care. The edema resolved spontaneously within four days.

Discussion:

Presternal lymphedema is a rare complication of mumps, more commonly described in children [2]. The mechanism is thought to involve transient lymphatic obstruction due to inflammation of the salivary glands, especially the submandibular glands [3].

Although alarming in appearance, this finding is benign and self-limiting. Imaging or further investigations are typically unnecessary unless there are signs of infection, abscess, or airway compromise. Recognizing this complication—Gelli’s sign—[1] helps clinicians manage it conservatively and avoid unwarranted diagnostic procedures.

Conclusion:

Presternal edema is an uncommon but benign complication of mumps. Clinician awareness of Gelli’s sign is essential for appropriate management, particularly in adult patients, where it may be even more unexpected.

Funding:None.

Conflict of interest:None.

Ethical considerations: Free and informed consent for publication was obtained from the patient.