Abstract
Epstein-Barr virus (EBV) is a common cause of infectious mononucleosis, but its association with acute pancreatitis is exceedingly rare, particularly in young adults. We present the case of a 21-year-old female who developed acute pancreatitis in the context of laboratory-confirmed primary EBV infection. The patient presented with persistent epigastric pain, gastrointestinal symptoms, fever, and features typical of mononucleosis. Laboratory evaluation revealed significantly elevated amylase and lipase levels, transaminitis, and lymphocytosis with atypical lymphocytes. Abdominal ultrasound demonstrated splenomegaly without gallstones or biliary abnormalities. EBV infection was confirmed by positive viral capsid antigen (VCA) IgM serology, with exclusion of other common etiologies of pancreatitis. Supportive management, including intravenous fluids, analgesia, and gradual reintroduction of enteral nutrition, resulted in full clinical and laboratory recovery within nine days. This case is consistent with previously reported instances of EBV-associated acute pancreatitis in young adults, which similarly describe favorable outcomes following conservative management. Clinicians should remain vigilant for this rare etiology, especially in patients presenting with pancreatitis and systemic viral features. Comprehensive diagnostic workup is essential to exclude more common causes and confirm the diagnosis. Further research is needed to elucidate the pathogenesis and optimal management of EBV-associated pancreatitis.