Abstract
We report a case of previously healthy 15½-year-old girl who presented with fever and vomiting. Notably, she developed mild scleral icterus and had imaging findings suggestive of acute acalculous cholecystitis (ACC). Targeted serological testing confirmed acute Epstein-Barr virus (EBV) infection. The patient improved with supportive care. This case highlights the potential for EBV to cause acute hepatobiliary pathology, emphasizes the importance of including viral etiologies in the differential diagnosis of febrile adolescents with hepatobiliary findings, and aims to raise awareness about this rare complication.