Acute Mononucleosis — Why Rest Comes First
Placeholder: acute EBV illness demands rest to limit splenic strain.
- 1–2 wk: Typical fever duration (placeholder note)
- ~50%: Splenomegaly incidence (placeholder note)
- Days 1–10: Bed rest advised (placeholder note)
- None: Activity allowed (placeholder note)
Acute phase management
Placeholder: symptomatic care, hydration, and strict rest during acute illness.
Weeks 2–3 — Reintroducing Light Movement
Placeholder: gentle activity resumes as acute symptoms fade.
- Week 2+: Walking allowed (placeholder note)
- 2–4 wk: Fatigue duration (placeholder note)
- Light only: Non-contact exercise (placeholder note)
- Not yet: Contact sport (placeholder note)
Graded activity return
Placeholder: activity increases gradually, guided by symptom tolerance.
Serial Ultrasound — Tracking Spleen Size
Placeholder: ultrasound measures spleen length to guide clearance timing.
- ~Week 3: First scan (placeholder note)
- ≤12 cm: Normal spleen length (placeholder note)
- 1–2 wk: Repeat interval (placeholder note)
- Abdominal US: Modality (placeholder note)
Monitoring protocol
Placeholder: repeat scans confirm the spleen is shrinking toward normal.
Spleen Size Normalization Timeline
Placeholder: most spleens normalize within four to six weeks.
- 4–6 wk: Median normalization (placeholder note)
- Weeks 2–3: Rupture risk window (placeholder note)
- <0.5%: Rupture incidence (placeholder note)
- Up to 12 wk: Delayed cases (placeholder note)
Normalization variability
Placeholder: normalization speed varies by individual and initial severity.
Clearing Athletes for Contact Sport
Placeholder: clearance requires normal spleen size and no symptoms.
- ≥4 wk: Minimum time off (placeholder note)
- US-confirmed: Clearance criteria (placeholder note)
- Cleared last: Contact sports (placeholder note)
- Earlier ok: Non-contact return (placeholder note)
Return-to-play decision
Placeholder: clinicians combine ultrasound findings with symptom resolution.
Placeholder: never clear contact sport while spleen remains enlarged.