17 August, 2011
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Mononucleosis in Athletes
More commonly called the "kissing disease," mononucleosis is a virus that can cause fever, sore throat, swollen lymph nodes and an enlarged spleen. Fatigue is also a symptom, making the virus a potential impediment for athletes. Because of splenic enlargement, participation in sports is dangerous. Contact or pressure can cause the spleen to rupture. Though you may feel pressured to return quickly to your sport, follow your doctor's advice and wait until your symptoms have receded.
Linked to both the Epstein-Barr virus and cytomegalovirus, mononucleosis -- or mono -- is spread by saliva and close contact. The infection may develop at any age, but mostly affects teenagers between ages 15 and 17. Mono is slow to develop, as its incubation period falls between 30 and 50 days. You may feel an onset of fatigue, headache and a sore throat that slowly worsens. Tonsils often swell and develop a whitish-yellow covering. The lymph nodes on your body -- particularly those behind your ears and on your neck -- also swell and may be painful to the touch.
Diagnosis and Treatment
A blood test will determine whether you have mono or another infection. Diagnosis is important -- especially for athletes -- to avoid complications like upper airway obstruction and splenic ruptures. Symptoms of mono vary with each individual. While you might present with symptoms severe enough for hospitalization, your friend might only have a mild fever and some fatigue. As a virus, mono doesn't respond to antibiotics -- it must run its course. Typically, rest, fluids and an anti-inflammatory medication to reduce swollen lymph nodes are recommended. You may, however, need antibiotics if you concurrently suffer from strep throat or another infection.
Mononucleosis and the Spleen
Though fatigue, fever and swollen tonsils can negatively impact an athlete's health, the enlargement of the spleen is the major barrier to returning to activity. Approximately 50 percent of mononucleosis cases result in splenic enlargement or splenomegaly in the second or third week of illness. Your spleen, located in the upper left portion of your abdomen, functions as a blood filtering and storage organ. As such, damage to this organ, particularly in its enlarged state, can result in massive internal bleeding. An October 2004 report published in the "American Family Physician" states that splenic rupture is rare, occurring in only 0.1 percent of the affected population. However, caution is recommended; athletes need doctor approval to return to activity.
Returning to Activity
Though four weeks is the typical amount of time it takes for your blood tests to show normal levels of lymphocytes -- cells that attack and kill invading pathogens -- no time frame has been established for mono sufferers to return to athletic activity. Close monitoring and abdominal examination can help your doctor determine the progress of your illness. Rupturing the spleen requires emergency surgery and is potentially fatal. Splenic rupture is not the only concern, however, when returning to sports. Athletes who endured a fever and severe fatigue may experience a loss in strength and cardiovascular endurance. Getting back into condition is paramount, but must be done gradually to avoid additional stress on the body.
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