Epstein-Barr virus induced hyperbilirubinemia and jaundice: a case report

Background Ebstein-Barr virus (EBV) is the primary cause of infectious mononucleosis (IM), which typically presents with fever, sore throat, and malaise, and is often associated with mild elevations in liver enzymes. Case presentation We present the case of a 30-year-old postpartum Caucasian female who developed painless jaundice. Laboratory evaluation revealed markedly elevated total and direct bilirubin, anemia, and exam showed splenomegaly. Serologic testing confirmed acute EBV infection and additional laboratory findings suggested a hemolytic process, including positive direct antiglobulin test and reticulocytosis. Her symptoms and liver function abnormalities gradually improved with supportive care, underscoring EBV as a rare cause of significant hyperbilirubinemia in adults. Conclusion This case highlights the need to maintain a broad differential when evaluating hyperbilirubinemia, including atypical viral etiologies such as Epstein-Barr virus.