Atypical Presentation of Epstein-Barr Virus Infectious Mononucleosis With Cholestatic Hepatitis and Hyperbilirubinemia in a Young Adult: A Case Report.

ABSTRACT

This case report details the presentation of a 24-year-old male of South Asian descent with an atypical manifestation of Epstein-Barr virus (EBV) infectious mononucleosis, characterized by cholestatic hepatitis and hyperbilirubinemia. The patient initially presented with common symptoms of sore throat, intermittent fever, and general malaise, which subsequently progressed to include nausea and vomiting. Laboratory investigations revealed significantly elevated liver enzymes and bilirubin levels. Comprehensive serological testing confirmed an EBV infection. Despite the absence of typical risk factors, this case underscores the importance of considering EBV in the differential diagnosis for young adults presenting with both infectious symptoms and abnormal liver function tests. Early recognition of such atypical presentations is crucial for guiding appropriate management and avoiding unnecessary diagnostic procedures.