Infectious Mononucleosis

Abstract

A two-step infection by the Epstein-Barr virus accounts for the characteristic features of infectious mononucleosis (IM). New serologic tests for viral antigens exist, but a rapid kit test for heterophil antibody usually suffices to confirm the diagnosis. General management is supportive only. Splenic rupture is very rare, almost never fatal if diagnosed early, and, in most cases, is probably best treated by splenectomy. Athletes tend to recover from IM faster than nonathletes. When the spleen returns to normal size, the athlete can return to contact sports, though it may take 3 to 6 months for an elite athlete to regain top form.

Training Room Management of Medical Conditions: Infectious Diseases

“…Although delayed splenic rupture is possible, it is generally felt that the risk for splenic rupture with IM is greatest in the first 3 weeks of the illness [36]. Based on this observation, a period of recovery for at least 3 weeks following symptom onset has been proposed by some authors, whereas others suggest 5 to 6 weeks or longer may be more appropriate [39,40]. A 3-week recovery period (no physical activity) from time of symptom onset, followed by resumption of light activities in asymptomatic individuals (fourth week) and return to full participation (fifth week) is an algorithm that has been suggested in a recent preparticipation physical examination monograph [41].…”