A high school athlete with infectious mononucleosis asks when she may resume play. What is the usual guideline?

A high school athlete with infectious mononucleosis asks when she may resume play. What is the usual guideline?

• A. After 3 weeks, she may begin lifting weights but not full sports
• B. After 4 weeks, she may return to full play and practice
• C. At 4 weeks, she must have an exam to determine fitness for play
• D. She may engage in moderate exertion and practice after 3 weeks

Answer: (C)

Infectious mononucleosis can cause enlargement of the spleen, and resuming intense activity too soon increases the risk of splenic rupture. Because of this, athletes should be evaluated by a clinician before returning to full play. The usual approach is to wait about four weeks and then have a medical clearance exam to determine fitness for sports. This exam typically assesses whether fever and fatigue have resolved and whether the spleen and liver have returned to normal size and function, ensuring it’s safe to resume activity. While some options suggest starting lighter activity earlier, or returning to full play without formal clearance, those approaches can miss ongoing splenic enlargement or lingering symptoms. The four-week exam provides a safety check before any return to full exertion or contact.

Infectious mononucleosis can cause enlargement of the spleen, and resuming intense activity too soon increases the risk of splenic rupture. Because of this, athletes should be evaluated by a clinician before returning to full play. The usual approach is to wait about four weeks and then have a medical clearance exam to determine fitness for sports. This exam typically assesses whether fever and fatigue have resolved and whether the spleen and liver have returned to normal size and function, ensuring it’s safe to resume activity.

While some options suggest starting lighter activity earlier, or returning to full play without formal clearance, those approaches can miss ongoing splenic enlargement or lingering symptoms. The four-week exam provides a safety check before any return to full exertion or contact.