How do you know if you have mono or strep

How do you know if your sore throat is caused by mononucleosis?

Having a sore throat can be a symptom of many conditions, and many people wonder if their own sore throat might be a sign of something more serious than the common cold. Specifically, infectious mononucleosis ("mono") and infection with Streptococcus bacteria ("strep throat") are two conditions that both produce an extremely painful sore throat.

Like the common cold, infectious mononucleosis is caused by a viral infection. The virus responsible for mono is called the Epstein-Barr virus, abbreviated EBV. EBV is a very common virus worldwide, and studies show that up to 95% of the U.S. population has been infected with EBV at some point in their lives. EBV infection, especially if it occurs early in childhood, does not always cause illness, or it may cause a very mild illness that is not distinguishable from colds or other mild illnesses of childhood. However, when infection first occurs during the teen years or in young adulthood, infectious mononucleosis will develop in up to 50% of cases.

What are the symptoms of mono?

  • fatigue,
  • sore throat,
  • swollen lymph nodes, and
  • fever.

Enlargement of the spleen and inflammation of the liver may also occur. Severe complications are very rare, and the condition gradually resolves on its own. Because mono is caused by a virus and not bacteria, antibiotics are of no benefit. Therefore, treatment is directed at relieving the symptoms, which may persist for one to two months.

What are the differences between mononucleosis and strep throat?

In contrast to infectious mononucleosis, strep throat is caused by a bacterial infection. As with mono, the symptoms of strep throat can include:

  • sore throat,
  • swollen lymph nodes, and
  • fever.

Strep throat is also common in children and teens. In cases of strep throat, the tonsils are often enlarged, and red and white patches can sometimes be seen in the throat. If not treated, strep throat can lead to complications, such as rheumatic fever, later in life. Treatment involves antibiotics, and people with strep throat usually feel better after taking the antibiotics for a day or two.

Mono and strep throat account for only a small percentage of sore throats. The majority of sore throats are minor discomforts that occur in combination with other symptoms of the common cold. However, high fever, swollen lymph nodes in the neck, enlarged tonsils, and extremely painful sore throat are all warning signs that warrant a visit to the doctor to rule out mono or strep throat. Your doctor can perform simple tests in the office to determine whether your symptoms may be due to mono or strep throat.

References

Medically reviewed by Robert Cox, MD; American Board of Internal Medicine with subspecialty in Infectious Disease

REFERENCE:

UpToDate.
Patient information: Infectious mononucleosis (mono) in adults and adolescents (Beyond the Basics).

Mononucleosis, also called mono or the kissing disease, is an infection caused by the Epstein-Barr virus. It’s most common in teens and young adults. It usually goes away on its own without causing serious illness.

The early symptoms of mononucleosis are like those of the flu. You might have:

  • Severe fatigue
  • A headache
  • A sore throat, which can be severe
  • Chills followed by a fever
  • Muscle aches

After a day or two, you may also have:

  • Swollen lymph nodes and tonsils
  • A measles-like rash on your face or body. It might begin suddenly after you’ve taken amoxicillin for a severe sore throat.
  • Tiny red spots or bruise-like areas inside your mouth, especially on the roof of your mouth (palate)
  • Soreness in your upper left belly because of an enlarged spleen

How Long Do Symptoms Last?

Signs of mono usually show up 4 to 6 weeks after you’re infected with the virus. Most people feel better after 2 to 4 weeks, but they may be tired for several weeks after that. Symptoms can sometimes last 6 months or more.

When to Call Your Doctor

Get medical care right away if you have severe belly pain or blurry vision, if you feel lightheaded or confused, or if you pass out. You could have a ruptured spleen.

Talk to your doctor if:

  • You have mono symptoms for longer than 10 days or you have a severe sore throat for more than a day or two. Your doctor will want to rule out other illnesses, such as strep throat.
  • You have a severe headache that won’t go away and a stiff neck, which might be signs of meningitis
  • You get a rash of many tiny red spots (petechiae), which could be a sign of a lack of platelets in your blood or another serious illness such as meningitis
  • You have yellow skin or eyes (jaundice), which may be a sign of hepatitis
  • You have signs of other illnesses including swollen lymph nodes all over your body, trouble breathing, a long-lasting fever over 101.5 F, or weakness in your arms and legs

Can mono be mistaken for strep?

Signs of mono usually show up about 1–2 months after someone is infected with the virus. Its most common symptoms are sometimes mistaken for strep throat or the flu.

What does mono feel like in the beginning?

Mono may begin slowly with fatigue, a general ill feeling, headache, and sore throat. The sore throat slowly gets worse. Your tonsils become swollen and develop a whitish-yellow covering. Often, the lymph nodes in the neck are swollen and painful.

What is worse strep throat or mono?

Although both infections can result in sore throat, mononucleosis will make a person feel exhausted, as exhaustion is not a symptom of strep throat. While strep throat will usually lead to enlarged tonsils and the probability of red or white patches in the person's throat.

How do I check myself for mono?

Self-Checks.
A high fever..
Severe or persistent abdominal pain..
Severely swollen throat or tonsils..
Difficulty breathing or swallowing..
Limb weakness..
A severe headache..