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Differences Between Mono and Strep: Symptoms, Causes, and Treatment Options

mono and strep difference

Accurate diagnosis is the linchpin of effective medical treatment. To give an illness the best care possible, the underlying cause must be found. This becomes particularly important when dealing with illnesses that present similar symptoms, making it challenging to distinguish one from another.

A study that was published in the American Journal of Medicine states that getting accurate diagnoses is essential to providing quality medical care. It underscores the importance of follow-up and feedback in minimizing diagnostic errors. This highlights the need for proper medical evaluation instead of self-diagnosis, which may lead to incorrect conclusions.

One common scenario where accurate diagnosis is critical is distinguishing between mononucleosis and strep throat. These two illnesses share similar symptoms, making it difficult to determine the actual cause of discomfort without a professional medical examination.

Mononucleosis: The ‘Kissing Disease’ vs Strep Throat: A Common Bacterial Infection

Mononucleosis, also known as “mono,” is a viral infection caused by the Epstein-Barr virus. This virus is commonly transmitted through saliva, earning mono its nickname, “kissing disease.” It can, however, spread through blood and sperm during sexual contact, blood transfusions, and organ transplants. 

Strep throat, on the other hand, is a bacterial infection that can cause your throat to feel sore and scratchy. It’s caused by infection with Streptococcus pyogenes bacteria, or group A streptococcus. These bacteria are highly contagious and can spread through airborne droplets when an infected person coughs or sneezes, as well as through shared food or drinks.

Differentiating Mono and Strep

While both mononucleosis and strep throat can cause a sore throat and fever, there are some key differences that can help differentiate between the two.

Symptom Differences

Mononucleosis is frequently accompanied by extreme fatigue that can last for weeks or even months. Additionally, mono symptoms may include swollen lymph nodes, enlarged spleen, skin rash, and a severe sore throat or tonsillitis.

The symptoms of strep throat, on the other hand, typically include a sharply painful sore throat, difficulty swallowing, red, swollen tonsils (which may also have white streaks or patches of pus), small red spots on the soft or hard palate (the region at the back of the roof of the mouth), and headaches. Notably, strep throat does not typically cause extreme fatigue, skin rash, or an enlarged spleen.

Course of Illness

Mono and strep also differ in their course of illness. While the symptoms of strep throat generally improve within a few days to a week with appropriate antibiotic treatment, symptoms of mono can linger for weeks or even months. Furthermore, while strep throat can occur multiple times in a person’s life, mono typically only occurs once.

Age of Common Occurrence

While both illnesses can affect individuals of any age, they do have different age groups where they are most commonly observed. Mono is often seen in teenagers and young adults, particularly those in high school or college. On the other hand, strep throat is more common in children aged 5 to 15, although it can occur in adults as well.


Mono and strep also differ in their modes of transmission. Mono, caused by the Epstein-Barr virus, is typically spread through saliva—hence its nickname, the “kissing disease.” It can also be spread through blood and shared items like toothbrushes and drinking glasses.

When an infected person coughs or sneezes, the group A Streptococcus bacteria that causes strep throat spreads easily through airborne droplets, making it extremely contagious. It can also spread through shared food, beverages, or eating utensils.


The potential complications of mono and strep throat also differ. Complications from mono can include an enlarged spleen, problems with the liver, and, in rare instances, heart problems.

In contrast, if left untreated, strep throat can result in more serious complications like rheumatic fever, which can damage the heart, along with kidney inflammation and other health problems.

It’s important to note that strep throat cannot turn into mono, as they are caused by different types of pathogens—a bacterium and a virus, respectively. It is conceivable for an individual to have both infections concurrently, though.

Management and Treatment Options for Mono 

Since mononucleosis is caused by a virus, antibiotics are not an effective treatment. Instead, management of mono primarily involves relieving symptoms and includes:

  • Rest: The most common symptom of mono, fatigue, can be severe and may last for several weeks. Adequate rest is crucial during this time.
  • Hydration: Drinking fluids can help alleviate fever and throat soreness.
  • Over-the-counter medication: Medications such as acetaminophen or ibuprofen, which lower fever and relieve pain, can be used to treat symptoms.
  • Avoiding contact sports and heavy lifting: Since mono can cause the spleen to swell, it’s important to avoid activities that might cause abdominal injury, such as contact sports or heavy lifting.

Management and Treatment Options for Strep

Contrary to mono, strep throat is caused by bacteria and can be treated with antibiotics. Reducing symptoms, avoiding complications, and getting rid of the infection are the main objectives of strep throat treatment. Treatment usually involves:

  • Antibiotics: Penicillin or amoxicillin is most often prescribed. Even if symptoms subside before the antibiotic’s recommended duration, it is still important to take the entire course as directed.
  • Over-the-counter medication: Similar to mono, fever reducers and over-the-counter painkillers can be used to treat symptoms.
  • Rest and hydration: Plenty of sleep and hydration can help the body recover.

Please note that while these are general guidelines for treatment, individual care may vary, and it’s always important to consult with a healthcare provider for personalized advice.

Prevention: The Best Form of Treatment

Eliminating the risk of contracting strep throat and mononucleosis is, in fact, the best course of action. The severity and rate of spread of these diseases can both be significantly decreased by taking easy preventive actions.

For mono, since it is commonly spread through saliva, avoid sharing utensils, toothbrushes, or anything else that may come into contact with another person’s mouth. In the same way, leading a healthy lifestyle with regular exercise, a balanced diet, and plenty of sleep can strengthen your immune system and reduce your vulnerability to illness.

It is important to practice good hygiene when it comes to strep, including frequent hand washing, covering your mouth when you cough or sneeze, and avoiding close contact with infected individuals. If you are diagnosed with strep throat, avoid going to work or school until you have taken antibiotics for at least 24 hours. This will help you avoid infecting other people.

Keep in mind that, despite the possibility of discomfort, both conditions are treatable with the appropriate attention. By understanding the differences between mono and strep, you’ll be better equipped to navigate these health challenges should they arise.

Stay informed, stay healthy!


  • Diane Silva

    Diane is a travel enthusiast, content creator, and master storyteller, capturing her adventures through captivating blogs and engaging vlogs. With a passion for the great outdoors and a love for literature, she brings a unique perspective to the travel world. Whether she's exploring hidden gems or discussing the latest trends, Diane is your go-to source for all things travel and beyond.