Epstein-Barr Virus Masking Acalculous Cholecystitis in a 19-Year-Old Male.

Epstein-Barr virus (EBV), a member of the Herpesviridae family, is widely distributed and highly prevalent worldwide. It is known to cause infectious mononucleosis, characterized by symptoms such as fever, pharyngitis, lymphadenopathy, and atypical lymphocytosis in adults. In the pediatric population, acute EBV infection is typically asymptomatic.  Acute cholecystitis, on the other hand, refers to acute inflammation within the gallbladder, typically due to the obstruction of the cystic duct secondary to gallstones. Patients will often present with right upper quadrant pain positive for Murphy sign, among other manifestations such as fever, fatigue, and jaundice. EBV and acute cholecystitis rarely coincide with one another. This abstract presents a comprehensive analysis of a clinical case that illustrates how an EBV infection obscured the clinical presentation of acute cholecystitis. This case underscores the necessity for a nuanced approach to the diagnosis, especially when the standard of care diagnostic criteria become inconclusive. However, hepatocellular injury as a result of EBV infection is rare. In this case report, we present the case of a 19-year-old male who developed EBV-induced hepatitis, emphasizing the importance of considering EBV as a potential cause in similar clinical scenarios.