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Infectious Mononucleosis Advice — MRCGP AKT MCQ

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EasyInfectious DiseasesInfectious Mononucleosis AdviceMRCGP AKTUKMLAPARA

A 20-year-old female university student presents feeling generally unwell with fever, sore throat, malaise, and fatigue for the past week. On examination, she has posterior cervical lymphadenopathy, palatal petechiae, and mild splenomegaly. FBC shows lymphocytosis with atypical lymphocytes. A Monospot test is positive. What advice should be given regarding activities?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Avoid contact sports for at least 4 weeks

The presentation is typical of Infectious Mononucleosis (Glandular Fever), caused by Epstein-Barr Virus (EBV). Splenomegaly occurs in about 50% of cases, and there is a risk of splenic rupture, particularly with trauma. Therefore, NICE CKS recommends avoiding contact sports and strenuous activities for at least 4 weeks from the onset of symptoms (or longer if splenomegaly persists) to minimise this risk. Bed rest is not necessary unless severely fatigued. Immediate return to activity is unwise. Alcohol avoidance is usually advised while LFTs are deranged, but 6 months is excessive. Isolation is not usually required as transmission requires close contact (saliva).

Reference: https://www.nice.org.uk/guidance