“A women’s Lacrosse player has a bad sore throat, fever of 102, and malaise for a week. There are several cases of strep throat on campus. Competition for the season starts in one week.” (Mononucleosis)
Clinical Scenario: Mononucleosis
Mononucleosis is a common medical condition that affects thousands of athletes each year. Variability of this disease can present of a rare risk splenic rupture which can present sports medicine clinicians with a difficult return to play decisions. Currently there are no guidelines that are evidence based for management of an athlete that has mononucleosis. The incubation period are 30 to 50 days, controlling the disease can be difficult especially in a school population. Athletes ranging from 15 to 19 years old are a particular concern because physicians are often pressured by parents, coaches, and patients to let the athlete resume athletic competition soon than they should. If an athlete returns to play too early the athlete is optionally at risk for a splenic rupture. An estimated splenic rupture to occur is 0.1% of all cases of mononucleosis2. There are no controlled clinical trials for athletes with mononucleosis to return to play because it would be unethical and possibly fatal.
Mononucleosis is caused by the Epstein-Barr virus which is a member of the herpes virus family. This virus eventually infects almost 90% of adults but many individuals are not aware they had the disease, which may be an expression of the variability of the immune response to infection1. The incidence of this disease in developed countries has shown that it infects mainly adolescents and young adults. It is estimated that 30% to 50% of freshman entering collage remain susceptible to infect...
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Mononucleosis is spread through saliva. If you're infected, you can help prevent spreading the virus to others by not kissing them and by not sharing food, dishes, glasses and utensils until several days after your fever has subsided and even longer, if possible. The Epstein-Barr virus may persist in your saliva for months after the infection. No vaccine exists to prevent mononucleosis.
Mononucleosis is an infection that can put an athlete out of play for up to 3 weeks. An evaluation can confirm that an athlete has the infection. The timetable for return to play varies throughout studies and should be based on the symptoms of the athlete. If the athlete returns to play to early serious consequences may occur. It is necessary and appropriate to withhold participation of the athlete until the symptoms of mononucleosis are asymptomatic.
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