Exercise and the Athlete With Infectious Mononucleosis

Area of Science:

• Sports Medicine
• Infectious Diseases
• Public Health

Background:

• Infectious mononucleosis (IM) is a common viral illness affecting young athletes.
• Accurate diagnosis and management are crucial for athlete health and performance.
• Traditional diagnostic methods for IM can be unreliable.

Purpose of the Study:

• To outline the appropriate management of active individuals with infectious mononucleosis (IM).
• To address diagnostic challenges, splenomegaly assessment, and disease status monitoring.
• To explore the relationship between IM and chronic fatigue syndrome (CFS) and exercise risks.

Main Methods:

• Comprehensive literature search of Ovid/MEDLINE and PubMed databases (January 1996-June 2015).
• Inclusion of "similar articles," reference lists, and personal files to supplement search results.
• Review focused on diagnostic accuracy, disease monitoring, and risk assessment for athletes.

Main Results:

• Clinical IM diagnosis is unreliable; Epstein-Barr antigen testing offers higher sensitivity and specificity.
• Splenomegaly assessment requires standardized laboratory methods (e.g., ultrasonography) accounting for individual variations.
• Key risks include splenic rupture (0.1%-0.5%) and progression to chronic fatigue; 3-4 weeks of activity restriction followed by graded reconditioning is recommended.

Conclusions:

• Accurate diagnosis and conservative management of IM in athletes minimize long-term health risks.
• Avoiding splenic rupture and CFS progression through appropriate activity restriction is paramount.
• Full recovery and return to athletic performance are typically achieved with 2-3 months of management.