Ultrasonographic evaluation of splenic enlargement in athletes with acute infectious mononucleosis

Hosey, Robert G.; Kriss, Vesna Martich; Uhl, Timothy L.; DiFiori, John P.; Hecht, Suzanne; Wen, Dennis Y.

doi:10.1136/bjsm.2008.050807

Cited by 39 publications

(35 citation statements)

References 5 publications

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“…Most cases of splenomegaly had resolved by 4-6 weeks and there was a predictable rate of splenic regression of approximately 1% each day after reaching peak enlargement. 17 Similar results were reported in another paper, with normalisation of spleens at one month in 84% of participants. w62 One study recommended that athletes wanting to return to contact sport at 3-4 weeks should have an ultrasound examination to ensure that the spleen had returned to normal size.…”

Section: When Is It Safe To Return To Sports?supporting

confidence: 88%

Infectious mononucleosis

Lennon

Crotty²,

Fenton

2015

BMJ

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Section: When Is It Safe To Return To Sports?supporting

confidence: 88%

Infectious mononucleosis

Lennon

Crotty²,

Fenton

2015

BMJ

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“…33,45 In ultrasound studies, peak spleen size is typically noted within the first 2 weeks of illness, but may extend to 3.5 weeks. 18 The majority of spleen injuries occur within the first 21 days of illness and are exceedingly rare at >28 days. 21,26,43 Fortunately, splenic rupture is rare, occurring in <0.5% of those with IM, but its consequences can be severe.…”

Section: Return-to-play Considerationsmentioning

confidence: 99%

Return to Play After Infectious Mononucleosis

Becker

Smith

2014

Sports Health: A Multidisciplinary Approach

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Context:Infectious mononucleosis is a disease primarily of adolescence and early adulthood. The risk of splenic injury and chronic fatigue make return-to-play decisions a challenge for the clinician caring for athletes with infectious mononucleosis.Evidence Acquisition:Data were obtained from the PubMed and MEDLINE databases through December 2012 by searching for epidemiology, diagnosis, clinical manifestations, management, and the role of the spleen in infectious mononucleosis.Study Design:Clinical review.Level of Evidence:Level 4.Results:Infectious mononucleosis is commonly encountered in young athletes. Its disease pattern is variable and can affect multiple organ systems. Supportive care is the cornerstone, with little role for medications such as corticosteroids. Physical examination is unreliable for the spleen, and ultrasound imaging has limitations in its ability to guide return-to-play decisions. Exercise does not appear to place the young athlete at risk for chronic fatigue, but determining who is at risk for persistent symptoms is a challenge.Conclusion:Return-to-play decisions for the athlete with infectious mononucleosis need to be individualized because of the variable disease course and lack of evidence-based guidelines.

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“…In a study similar to ours published in 2008, Hosey at al investigated the role of weekly ultrasonography in determining when 20 athletes with infectious mononucleosis could return to contact sports; these assessments continued until splenomegaly resolved. 17 Th e authors observed a mean increase in splenic length of 36-month period from August 2004 through July 2007. We identifi ed all patients who had been admitted to our hospital's otolaryngology unit with acute tonsillitis.…”

Section: Discussionmentioning

confidence: 94%

Return to Contact Sports following Infectious Mononucleosis: The Role of Serial Ultrasonography

et al. 2011

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Splenic rupture is a rare but potentially fatal complication of infectious mononucleosis. Athletes returning to contact sports following infectious mononucleosis are at potential risk of splenic rupture secondary to abdominal trauma. No clear consensus exists as to when it is safe to allow these athletes return to contact sports. Suggested periods of abstinence have ranged from 2 weeks to 6 months. We outline our experiences with the use of abdominal ultrasonography at 1 month aft er the diagnosis of infectious mononucleosis as a means of determining when athletes can safely return to contact sports. Our study group was made up of 19 such patients (mean age: 16.7 yr). We found that 16 of these patients (84%) had normal splenic dimensions on ultrasonography 1 month aft er diagnosis, and they were therefore allowed return to contact sports. While the remaining 3 patients had an enlarged spleen at 1 month, their splenic dimensions had all returned to normal when ultrasonographic examination was repeated at 2 months postdiagnosis. We conclude that serial abdominal ultrasonography allows for informed decision making in determining when athletes can safely return to contact sports following infectious mononucleosis.

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Ultrasonographic evaluation of splenic enlargement in athletes with acute infectious mononucleosis

Cited by 39 publications

References 5 publications

Infectious mononucleosis

Infectious mononucleosis

Return to Play After Infectious Mononucleosis

Return to Contact Sports following Infectious Mononucleosis: The Role of Serial Ultrasonography

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