H-Index
18
Scimago Lab
powered by Scopus
eISSN: 1941-5923
call: +1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Logo

Medical Science Monitor Basic Research
MSMbanner

Annals
ISI-Home

Epstein-Barr Virus Causing Clinical Jaundice and Acute Acalculous Cholecystitis in a Previously Healthy 17-Year-Old Girl

Challenging differential diagnosis, Rare coexistence of disease or pathology

Kevin G. Harvey, Joshua G. Tice, Adam Sigal

USA Department of Emergency Medicine, Reading Hospital – Tower Health, West Reading, PA, USA

Am J Case Rep 2021; 22:e932285

DOI: 10.12659/AJCR.932285

Available online: 2021-09-08

Published: 2021-10-13


#932285

BACKGROUND: Infectious mononucleosis secondary to Epstein-Barr Virus is a common infection in young adults. Infection usually involves a self-limiting course of fevers, sore throat, malaise, and myalgias. Transaminitis is a relatively common complication; clinical jaundice, however, is rare. This case report highlights an uncommon complication of Epstein-Barr Virus infection in which hepatocellular injury led to clinical jaundice as well as radiologic evidence of gallbladder pathology mimicking acute calculous cholecystitis.
CASE REPORT: A 17-year-old girl with no prior medical history presented to our Emergency Department 1 week after being diagnosed with infectious mononucleosis. She was hemodynamically stable and her physical exam was notable for scleral icterus with right upper quadrant tenderness and positive Murphy’s sign. Multiple imaging modalities performed showed gallbladder wall thickening without common bile duct dilatation. A hepatobiliary iminodiacetic acid (HIDA) scan showed evidence of hepatocyte dysfunction with normal gallbladder filling. The imaging results obtained in conjunction with her laboratory testing and active infectious mononucleosis infection confirmed the patient’s presentation was a result of her Epstein-Barr virus infection and did not require surgical intervention for cholecystectomy.
CONCLUSIONS: This case report highlights a rare complication of Epstein-Barr Virus infection and demonstrates the utility of interpreting hepatic function testing in conjunction with relevant imaging modalities in cases of clinical jaundice. By doing so, we were able to conclude the patient’s gallbladder pathology was related to acute acalculous cholecystitis (AAC) and did not warrant surgical intervention. The patient was given supportive care measures and made a full recovery.

Keywords: Epstein-Barr Virus Infections, Infectious Mononucleosis, Jaundice



Back