From the Research
Patients with mononucleosis (mono) should avoid strenuous physical activity and contact sports for at least 8 weeks after diagnosis, as recommended by the most recent and highest quality study 1. This is due to the risk of splenic rupture, a rare but serious complication of mono that can occur when the enlarged spleen is injured during physical activity. The spleen typically enlarges during the first few weeks of infection and may remain enlarged for several weeks afterward. Some key points to consider include:
- Light activities like walking are generally acceptable as tolerated.
- Patients should not return to full activity until cleared by a healthcare provider, who will assess whether the spleen has returned to normal size.
- This typically involves a physical examination and sometimes ultrasound imaging.
- Patients should also get adequate rest, stay hydrated, and take acetaminophen or ibuprofen as needed for fever and pain while recovering from mono.
- The risk of splenic rupture is higher in men under 30 within 4 weeks of symptom onset, and particular vigilance is required in this group 2.
- Should the patient wish to return to high-risk activities prior to 8 weeks, an ultrasound should be performed to ensure resolution of splenomegaly 2.