PMID- 34642291
OWN - NLM
STAT- MEDLINE
DCOM- 20211014
LR  - 20211105
IS  - 1941-5923 (Electronic)
IS  - 1941-5923 (Linking)
VI  - 22
DP  - 2021 Oct 13
TI  - Epstein-Barr Virus Causing Clinical Jaundice and Acute Acalculous Cholecystitis 
      in a Previously Healthy 17-Year-Old Girl.
PG  - e932285
LID - 10.12659/AJCR.932285 [doi]
AB  - 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.
FAU - Harvey, Kevin G
AU  - Harvey KG
AD  - Department of Emergency Medicine, Reading Hospital - Tower Health, West Reading, 
      PA, USA.
FAU - Tice, Joshua G
AU  - Tice JG
AD  - Department of Radiology, Reading Hospital - Tower Health, West Reading, PA, USA.
FAU - Sigal, Adam
AU  - Sigal A
AD  - Department of Emergency Medicine, Reading Hospital - Tower Health, West Reading, 
      PA, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20211013
PL  - United States
TA  - Am J Case Rep
JT  - The American journal of case reports
JID - 101489566
SB  - IM
MH  - *Acalculous Cholecystitis/diagnostic imaging
MH  - Adolescent
MH  - *Cholecystitis, Acute
MH  - *Epstein-Barr Virus Infections/complications/diagnosis
MH  - Female
MH  - Herpesvirus 4, Human
MH  - Humans
MH  - *Jaundice/etiology
MH  - Young Adult
PMC - PMC8522527
COIS- Conflict of interest:None declared
EDAT- 2021/10/14 06:00
MHDA- 2021/10/15 06:00
PMCR- 2021/10/13
CRDT- 2021/10/13 06:22
PHST- 2021/10/13 06:22 [entrez]
PHST- 2021/10/14 06:00 [pubmed]
PHST- 2021/10/15 06:00 [medline]
PHST- 2021/10/13 00:00 [pmc-release]
AID - 932285 [pii]
AID - 10.12659/AJCR.932285 [doi]
PST - epublish
SO  - Am J Case Rep. 2021 Oct 13;22:e932285. doi: 10.12659/AJCR.932285.