Infectious Disease in Sports Medicine

Athlete Vulnerability: Athletes face high infection risks due to strenuous exercise, close contact (locker rooms, team events), shared equipment, physical trauma, competitive stress, and sleep barriers.
Time Loss: Illness accounts for more time lost from competition than physical injury.
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Common Cold (Viral URI): Caused by Rhinoviruses, coronaviruses, RSV, etc. Duration is typically $7-10$ days. Treatment is symptomatic (Acetaminophen, Ibuprofen); antibiotics are not indicated.
Strep Throat: Bacterial pharyngitis typically caused by Group A Streptococcus. * Symptoms: Fever, exudate, and lymphadenopathy; usually lacks cough or rhinorrhea. * Treatment: Penicillin or Amoxicillin (Azithromycin if allergic) is used primarily to prevent Rheumatic Fever (heart valve damage) and suppurative complications.
Antibiotic Complications: Frequent issues include GI disruption and yeast infections. Serious risks include C. Diff colitis, antibiotic resistance, and hearing loss (aminoglycosides/macrolides).

Etiology: Caused by Epstein-Barr Virus (EBV), primarily spread through saliva.
Key Risks: * Splenomegaly: Enlarged spleen occurs in nearly all cases (visible on ultrasound), posing a risk of splenic rupture, most commonly in the first $3$ weeks of symptoms. * Return to Play (RTP): Minimum of $3-4$ weeks after symptom onset to minimize rupture risk, further guided by fatigue levels.

Viral Skin Infections: Includes Molluscum contagiosum (pox virus) and Herpes Simplex (clusters of painful blisters treated with Valcyclovir).
Fungal Infections: Tinea corporis (ringworm) is treated topically, while Tinea capitis (scalp) requires oral treatment for approximately $3$ months.
Bacterial Skin Infections: * Impetigo/Folliculitis: Often caused by Staphylococcus Aureus or Group A strep. * Cellulitis: Red, swollen skin requiring oral antibiotics (Cephalexin). * Abscess: Often involves MRSA (Methicillin-resistant Staphylococcus Aureus); may require drainage.
Gastroenteritis: Highly contagious fecal-oral transmission (Rotavirus, Norovirus). Management focuses on rehydration using isotonic fluids.

Return to Play (2026 Update): No mandatory isolation; athletes return as symptoms improve. Cardiac evaluation (EKG, Echocardiogram, Tn) is reserved for those with cardiorespiratory symptoms (palpitations, chest pain).