In mononucleosis with splenomegaly, how long should patients avoid contact sports?

• A. 1 month
• B. 1 week
• C. 3 months
• D. 6 months

Answer: (A)

When the spleen enlarges during mononucleosis, its capsule is more prone to rupture from blunt trauma. That rupture risk persists for weeks as the spleen gradually returns to normal size, so delaying contact sports is important to prevent a potentially serious complication. A practical and commonly taught duration is about one month, allowing time for the spleen to shrink and the risk to decrease. Shorter intervals, like a week, leave too much risk while longer intervals, such as several months, are unnecessary for most patients and unnecessarily delay recovery. If splenomegaly lingers, the restriction can be extended until the spleen has returned to normal size and the patient remains asymptomatic.