Resuming Physical Activity After Mono

Dear Ask The Doctor: My 17 year old son was sick for about a week with mono. His only symptom was extreme fatigue. He is definiely feeling better now (as of Tuesday, November 9th), but we know that he has to take it easy physically because of the danger of reoccurance and the danger of an enlarged spleen. If a doctor examines him to make sure that his spleen is not enlarged, do you think that there is any chance of him getting "clearance" to participate in a pretty big deal soccer tournament at Thanksgiving? Would that time frame be considered "too soon" for physical activity?

Dear Audrey:

As you know the most feared complication of Mononucleosis is enlargement of the spleen. In extreme cases, the spleen may rupture, causing sharp, sudden pain in the left side of the upper abdomen; emergency surgery might be needed.

To avoid risk of spleen rupture, I would suggest waiting at least one month before returning to vigorous activities, heavy lifting, roughhousing or contact sports. Rupture of the spleen results in severe bleeding and is a medical emergency, usually the other flu like symptoms might improve in a few weeks, however the spleen needs time to recover form inflammation. I would suggest you to have that physical exam performed; certainly his physician can give him a best answer after a detailed evaluation of his current condition.