| Summary: | <em>Mycoplasma pneumoniae</em> (<em>M. pneumoniae</em>) is a major cause of community acquired respiratory infections. And it also causes a number of extrapulmonary manifestations including cardiovascular, dermatological, musculoskeletal, and hematological systems. But, acute hepatitis without lung involvement is rare in adults. Here, we report a case of 32-year-old man who presented with fever, chilling, myalgia, and headache. Biochemical analysis showed severely impaired liver function and leukopenia. Laboratory tests and liver biopsy demonstrated a hepatocellular pattern of <em>M. pneumoniae</em>-associated acute hepatitis. Clinical symptoms and laboratory parameters are improved rapidly under treatment with macrolide. Therefore, We recommend that phsycians should consider a possibility of <em>M. pneumoniae</em> infection in acute hepatitis without lung and extrapulmonary involvement, when other more frequent causes have been excluded.
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