Can we prevent splenic rupture for patients with infectious mononucleosis?
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All patients with infectious mononucleosis should be considered at risk for splenic rupture since clinical severity, laboratory results, and physical exam are not reliable predictors of rupture (strength of recommendation [SOR]: B, case-control study). Clinical evidence indicates that most splenic ruptures occur within 4 weeks of symptom onset, which correlates with ultrasound data showing resolution of splenomegaly by 30 days from symptom onset (SOR: B, case-control study). Given the morbidity and mortality associated with splenic rupture, instruct patients to refrain from vigorous physical activity for 1 month after symptom onset (SOR: C, expert opinion).
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