Adolescent Epstein-Barr Virus Hepatitis Without Typical Mononucleosis Symptoms and Gilbert’s Syndrome: A Case Report

Epstein-Barr virus (EBV) is one of the most common infections worldwide that presents with a multitude of symptoms such as lymphadenopathy, fever, and malaise and has associations with Hodgkin's lymphoma. EBV can cause elevations in transaminase values and hyperbilirubinemia; however, EBV will rarely cause hepatitis with cholestatic features. Here we report a case of a 15-year-old male with a past medical history of potential Gilbert's syndrome who presented with jaundice, scleral icterus, mild abdominal pain, and low-grade fever. Further work-up revealed elevated transaminase values, abnormal coagulation studies, and thrombocytopenia. The patient was monitored and diagnosed with EBV hepatitis, then treated with supportive therapy and IV vitamin K for the resolution of abnormal coagulopathy. The following report presents a patient with EBV hepatitis without the typical presentation of EBV, with a process for diagnosing and managing patients.