Barreto Francisco, Nóbrega Sofia, Carvalhinha Carolina, Henriques Carolina, Faria Teresa
Internal Medicine, Hospital Central do Funchal, Funchal, PRT.
Cureus. 2024 Nov 3;16(11):e72925. doi: 10.7759/cureus.72925. eCollection 2024 Nov.
One of the main clinical manifestations of infection by the Epstein-Barr virus (EBV) is infectious mononucleosis. In this clinical syndrome, mild hepatitis with a slight elevation of aminotransferases is common. However, cholestasis is rare and usually occurs alongside a more severe, cytolytic hepatitis. This case report describes a 26-year-old male admitted to the emergency service with recurrent fever, odynophagia, and painful cervical lymphadenopathy, along with a skin rash after starting treatment with amoxicillin/clavulanate, and jaundice. The analytical assessment was consistent with cholestatic hepatitis, and the abdominal CT scan revealed hepatosplenomegaly. The diagnosis of EBV infection was confirmed by the presence of serological markers. This case aims to raise awareness of a rare manifestation of a common infectious agent in order to consider acute EBV infection in the differential diagnosis of cholestatic hepatitis in adult patients.
爱泼斯坦-巴尔病毒（EBV）感染的主要临床表现之一是传染性单核细胞增多症。在这种临床综合征中，转氨酶轻度升高的轻度肝炎很常见。然而，胆汁淤积很少见，通常与更严重的细胞溶解性肝炎同时发生。本病例报告描述了一名26岁男性因反复发热、吞咽痛、颈部疼痛性淋巴结病入院急诊，在开始使用阿莫西林/克拉维酸治疗后出现皮疹和黄疸。分析评估结果与胆汁淤积性肝炎相符，腹部CT扫描显示肝脾肿大。血清学标志物的存在证实了EBV感染的诊断。本病例旨在提高对一种常见感染因子罕见表现的认识，以便在成年患者胆汁淤积性肝炎的鉴别诊断中考虑急性EBV感染。
