Although the medical literature stresses the chronic nature of hepatic granulomas, we encountered, during a time span of several months, 2 patients with an acute febrile illness and hepatic involvement. Liver biopsy in both revealed epithelioid and mononuclear cell granulomas throughout the liver. Both patients had lymphocytosis and atypical forms in the peripheral blood. Heterophile antibody titers, performed multiple times in the course of their illnesses, were normal. Both patients recovered, 1 after 3 weeks and 1 after 6 weeks. Prior to our experience with these patients, we encountered 2 other patients who had similar clinical and laboratory findings. Because we were not sufficiently aware of the diagnostic possibilities, and because they were getting better, liver biopsy was not performed. Only after the third case was encountered were our suspicions aroused. There is one similar report in the literature. The clinical and laboratory features in their patients and in ours suggest an “infectious mononucleosis-like” illness. Similar biopsy findings are occasionally encountered in heterophile antibody-positive infectious mononucleosis. Our cases may be a new disease entity or a variant of one previously described.