EBV Acalculous Cholecystitis Secondary to Cystic Duct Node Lymphadenitis With Positive EBER in Situ Hybridization

Primary Epstein-Barr virus (EBV) infections are commonly subclinical and seen in adolescents. Although infectious mononucleosis is the most common manifestation, EBV has diverse manifestations within the gastrointestinal system. We describe a rare case of a 27-year-old woman with acute EBV acalculous cholecystitis and hepatitis secondary to cystic duct node lymphadenitis causing compression. EBV-encoded RNA in situ hybridization stained positive within sinusoids of liver and cystic duct lymphoid tissue but negative in gallbladder tissue. Work-up for a cause of hepatitis was negative except for serology confirming primary EBV infection. She underwent laparoscopic cholecystectomy, with a resolution of symptoms.