Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
This is an interesting case and from the information given seems to fit EBV-related viral acalculous cholecystitis as you suggest. However there is insufficient detail given in the text of the testing done to specifically confirm EBV in this case, although they may well have been done. Which EBV-specific serology tests were done and which were positive and which (eg anti-EBNA) were negative? White cells were raised, but was there a lymphocytosis and what was the proportion of atypical lymphocytes? You state that hepatitis A, B, and C serology was negative. Serology in the acute phase would not exclude hepatitis C infection. Was HCV serology tested at a later date? Was hepatitis E serology done? There is a case report of HEV infection associated with a heterophile antibody response.