A typical Presentation of Acute Infectious Mononucleosis (AIM) with Isolated Hyperbilirubinemia

Epstein - Barr virus (EBV) induced hepatitis and subsequent hyperbilirubinemia is a strikingly rare cause of jaundice. Lack of other common infectious mononucleosis symptoms makes the diagnosis difficult with history and physical exam alone. With differential diagnoses more commonly including HAV, HCV, and HBV hepatitis infections; alcoholic hepatitis; autoimmune hepatitis; and hepatocellular carcinoma, suspicion for EBV induced hepatitis is often low. We present a noteworthy case of isolated hyperbilirubinemia due to EBV virus confirmed with biopsy, without other infectious mononucleosis symptoms such as fever, sore throat, or splenomegaly. Furthermore, we review the pathophysiology, diagnosis, treatment, and prognosis of EBV-induced hepatitis