Strep Throat vs Mono: Know the Signs & Protect Yourself

Sore throats are a fact of life, but not all sore throats are created equal. Two conditions that often get confused are strep throat and mononucleosis, sometimes called “mono.” They share some of the same symptoms, but they have very different causes, treatments, and possible complications.

Getting the right diagnosis and treatment is essential to avoid serious health problems. While both conditions can be painful, they require different approaches to care.

This article will compare strep vs. mono, covering everything from causes and symptoms to diagnosis, treatment, prevention, and potential complications. Understanding the differences can help you get the right care when you need it most.

What is strep throat? What is mononucleosis?

Both strep throat and mononucleosis are infections that can cause a sore throat, but they’re actually quite different. Here’s a little more information about each.

Strep throat

Strep throat is a bacterial infection of the throat and tonsils. It’s caused by Streptococcus bacteria, specifically group A strep.

Although anyone can get strep throat, it’s most common in children between the ages of 5 and 15. Strep throat is contagious, so it’s easily spread in schools and daycare centers.

Mononucleosis (mono)

Mononucleosis, or “mono,” is a viral infection most often caused by the Epstein-Barr virus (EBV). Because it’s often transmitted through saliva, mono is sometimes called the “kissing disease.”

Mono is more common in people between the ages of 15 and 30. It’s highly contagious and spread through saliva and even respiratory droplets. Sharing food or drinks with someone who has mono can also spread the infection.

What causes strep and mono, and how do they spread?

Strep throat comes from group A Streptococcus bacteria. It spreads when someone coughs or sneezes near you. You can also get it by touching something that has the bacteria on it, then touching your face.

If you don’t treat strep throat, you can spread it for about three weeks. Once you begin taking antibiotics, you’re less likely to pass it on.

Mono is caused by the Epstein-Barr virus (EBV), and sometimes Cytomegalovirus (CMV). The virus lives in saliva, so people often get it through kissing or sharing drinks. Symptoms show up about a month after you get infected.

Comparing Symptoms: Strep Throat vs. Mono

Both strep throat and mono can make you feel pretty miserable. Here’s a look at the symptoms of each, along with some key differences that can help you tell them apart.

Symptoms of Strep Throat

Strep throat symptoms tend to come on quickly and may include:

• A sore throat that develops rapidly
• Pain when you swallow
• Fever
• Red and swollen tonsils, sometimes with pus or white patches
• Small red spots on the roof of your mouth (petechiae)
• Swollen lymph nodes in your neck
• Headache, stomach ache, and sometimes vomiting

Symptoms of Mononucleosis

The symptoms of mono, on the other hand, tend to develop more gradually and may include:

• Extreme fatigue
• Sore throat
• Fever
• Swollen lymph nodes in your neck and armpits
• Swollen tonsils, often with a whitish coating
• Enlarged spleen
• Skin rash

Overlapping Symptoms and Key Differentiators

As you can see, strep and mono share some symptoms, like sore throat, fever, and swollen lymph nodes. However, there are some important differences to keep in mind.

Strep throat comes on fast, while mono develops slowly. Fatigue is also much more pronounced with mono, and mono can also cause an enlarged spleen, which isn’t usually seen with strep.

Finally, strep throat may cause red or white patches in your throat, along with small red spots on the roof of your mouth.

Diagnosis: Identifying Strep Throat and Mono

Because strep throat and mono can present with similar symptoms, getting an accurate diagnosis is key.

Diagnosing Strep Throat

To diagnose strep throat, a healthcare provider will perform a physical exam. They’ll also likely order a rapid strep test (RADT), which involves taking a swab of your throat. If the RADT comes back negative, especially in children, a throat culture may be done as a backup.

Diagnosing Mononucleosis

Diagnosing mono also starts with a physical exam and assessment of your symptoms. A Monospot test, which looks for antibodies to the Epstein-Barr virus (EBV), is commonly used. A complete blood count (CBC) can also help, as it can reveal elevated white blood cells and atypical lymphocytes, which are often seen in mono.

If the Monospot test is negative but mono is still suspected, EBV-specific antibody tests might be considered.

Misdiagnosis Concerns

It’s important to be aware that misdiagnosis can happen due to the overlapping symptoms of strep and mono. Accurate testing is crucial to tell the two conditions apart and ensure you receive the right treatment.

Treatment Strategies: Managing Strep Throat and Mono

Strep throat and mono are managed in very different ways, so it’s essential to get an accurate diagnosis from your healthcare provider.

Treating Strep Throat

Strep throat is a bacterial infection, so antibiotics are usually the first line of defense. Typically, your doctor will prescribe penicillin or amoxicillin.

It’s important to take all of the antibiotics, even if you start feeling better after a couple of days. Stopping early can lead to complications, like rheumatic fever or kidney inflammation.

You can also take ibuprofen (Advil, Motrin) or acetaminophen (Tylenol) to bring down your fever and ease your sore throat pain.

Treating Mononucleosis

Mono is caused by a virus, so antibiotics won’t help. Unfortunately, there isn’t a specific antiviral medication for mono, either. Treatment focuses on managing your symptoms until your body fights off the infection.

Rest is crucial when you have mono. Your body needs all its energy to heal.

Staying hydrated is also important, so drink plenty of fluids.

As with strep throat, you can use pain relievers to manage your fever and sore throat.

One very important thing to remember with mono: Avoid strenuous activity and contact sports for at least 2 to 4 weeks. Mono can cause your spleen to enlarge, and heavy activity could cause it to rupture, which is a medical emergency.

Home Care and Remedies for Both Conditions

Whether you have strep or mono, some home remedies can help you feel better:

• Gargle with warm salt water (about 1/2 teaspoon or 3 grams of salt in 1 cup or 240 milliliters of water).
• Suck on throat lozenges (but only if you’re an adult or older child who won’t choke on them).
• Drink warm beverages and soups to soothe your sore throat.

Potential complications and long-term effects

Both strep throat and mononucleosis can lead to serious complications if left untreated.

Complications of strep throat

• Rheumatic fever is a serious inflammatory condition that can affect the heart, joints, brain, and skin.
• Post-streptococcal glomerulonephritis is a type of kidney inflammation.
• A peritonsillar abscess is a pocket of pus that forms behind the tonsils.
• Scarlet fever (scarlatina) is a disease that develops in some people with strep throat.

Complications of mononucleosis

• Splenic rupture is a rare but very serious complication that requires immediate medical attention.
• Hepatitis is an inflammation of the liver.
• Meningitis or encephalitis are rare conditions involving inflammation of the brain or its surrounding membranes.
• Post-viral fatigue syndrome is a prolonged feeling of fatigue that can last for weeks or months after the initial infection.

If you suspect you or your child may have strep throat or mononucleosis, it’s important to seek prompt medical attention to minimize the risk of complications.

Prevention and public health

Strep throat and mono are both contagious, but they spread in different ways. That means that preventing them requires slightly different approaches. However, there are some general things you can do to keep yourself and your community healthy.

• Wash your hands frequently. Use soap and water, and scrub for at least 20 seconds.
• Cover your mouth and nose when you cough or sneeze.
• Don’t share drinks, utensils, or other personal items.
• Stay home when you’re sick to avoid spreading infection.
• Avoid close contact with people who are infected.

In addition, schools and workplaces can help prevent the spread of these illnesses by:

• Encouraging sick people to stay home.
• Promoting good hygiene.
• Cleaning and disinfecting shared surfaces.

Vaccinations against other viral infections, like the flu, can also help reduce your risk of secondary bacterial infections like strep.

Frequently Asked Questions

Summary

Strep throat and mononucleosis have different causes, symptoms, diagnostic tests, and treatments. If you’re feeling unwell, it’s important to see a doctor or other healthcare provider for an accurate diagnosis and appropriate care. You can also take steps to lower your chances of catching or spreading either illness.