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Logo of brjsmedBritish Journal of Sports MedicineVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Br J Sports Med. 2007 October; 41(10): 698.
PMCID: PMC2465169


The issue of altered immune status in highly trained athletes is widely reported and attributed to a number of factors. This case study describes an interesting clinical case affecting a professional rugby player. The assumption is made that his deteriorating clinical status was secondary to exercised induced immunosuppression. A staphylococcal septicaemia, consequent upon an infected skin lesion, ultimately localised to a CT proven lung abscess. Excellent plain radiographs and CT images add to the discussion and confirm the focus of infection. However, if a state of chronic fatigue and “competition stress” are postulated as the cause of an “opportunistic” lung infection, objective measures of daily training load would strengthen the argument. Several serological markers identified with “persistent fatigue” are discussed but not quantified. Their tabulation would improve the presentation as would a finite list of the “return to play criteria”. This case reminds us to consider a systemic cause for failing adaptation in active patients.

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