Mono vs. Strep Throat: What You Need to Know

By Jennifer Nadel, MD
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March 25, 2022

Both mononucleosis (commonly called “mono”) and strep throat are infections that affect the throat, and both are extremely common.

Children are especially susceptible to strep throat, and young adults are especially susceptible to mono.

While these two infections can have similar symptoms, they are not the same, and require different treatments and precautions. 

In this article, I’ll go over the differences between mono and strep throat, including the symptoms of both infections. I’ll talk about risks for both, and precautions you can take to avoid infection, as well as how each is treated.

Finally, I’ll talk about when you should see a doctor about these conditions. 

Mono vs. Strep Throat Differences

Mono and strep throat are both infections that can cause discomfort in the throat and tonsils, but they have different causes and symptoms. 

What is mononucleosis?

Mononucleosis, otherwise known as mono, is most commonly caused by the Epstein-Barr virus (EBV), a member of the herpes virus family and one of the most common human viruses.

Other viruses can trigger mono symptoms as well. 

Mono is highly contagious. It is commonly known as the “kissing disease” because it can be spread through saliva—so kissing can spread mono.

But you can also get mono by sharing food, drinks, or utensils with someone who has mono, or if they cough or sneeze on you. 

At least one in four teenagers will develop a mononucleosis infection. 

There is no cure for mono.

The virus must run its course, which can take from a few weeks to more than a month to resolve.

What is strep throat?

Strep throat is a bacterial infection affecting the throat and tonsil area. It is caused by a bacteria known as group A streptococcus.

Like mono, strep throat is highly contagious.

Unlike mono, strep is treated with antibiotics, as it is caused by bacteria, not a virus. 

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Symptoms

While mono and strep throat share some common symptoms, there are some distinctive symptoms as well. 

Symptoms of mono

Mono symptoms come on gradually, showing up four to six weeks after initial exposure with EBV.

Most cases are mild, but symptoms can be severe in some cases. 

Primary signs in adults and adolescents are a sore throat and high fever. 

Other common symptoms include:

  • Extreme fatigue
  • Swollen glands in the neck and armpits
  • Swollen tonsils
  • Headache
  • Body aches and weakness
  • Night sweats
  • Pinkish-red or purple rash on the skin

Some people may experience an enlarged spleen or liver, but this is less common.

Symptoms usually last from two to four weeks before gradually improving, but some people feel fatigued for longer periods of time. 

Symptoms of strep throat

A common symptom of strep throat is a sore throat that comes on very quickly. This sore throat can make it painful or uncomfortable to swallow and eat.

Red, swollen tonsils are often a sign of strep as well.

Sometimes there will be white patches or pus on the tonsils. In addition to inflammation of the tonsils, someone infected with strep may experience swollen or inflamed lymph nodes in the front of the neck, and have a headache, fever, and body aches. 

If your sore throat is accompanied by a runny nose, watery eyes and a scratchy throat, it is possible that the cause is viral. In these cases, it may be a symptom of a common cold or another cause of a sore throat.

A rapid strep test may indicate whether or not you have strep throat.

To perform the test, a physician will take a sample of throat culture using a cotton swab at the back of your throat. 

Precaution and Risks

Both mono and strep throat are particularly common in young adults.

Mono is more commonly seen in people 15-30 years old. Strep throat is more common in children 5-15 years old. Due to the contagious nature of both these infections, children in a school setting tend to be at higher risk. 

In rare cases, both infections can lead to complications.

Mononucleosis can enlarge the spleen, which increases the chance of rupture.

To prevent this, it is important not to participate in strenuous activity or contact sports for at least two weeks after symptoms have subsided.

Rarely, mono can lead to additional complications including liver inflammation, anemia, heart inflammation, meningitis, or low platelet count. It’s important to let yourself rest and heal from the infection. 

Occasionally, untreated strep throat can lead to further complications such as, ear infections or deeper throat infections such as peritonsillar abscesses.

Treatment of strep throat can also prevent delayed complications such as rheumatic fever.

Treatments and Prevention

Strep throat is treated with oral antibiotics to treat the bacterial infection.

They reduce the severity of symptoms, and can help limit contagion when taken within 48 hours after symptom onset.

Antibiotics can also prevent further complications. Often patients feel relief after 24-48 hours. 

There is no cure for mono or medication to help the viral infection resolve faster. Instead, you should focus on treating your symptoms.

Try to soothe sore throat pain by gargling salt water or drinking and eating warm beverages and soups. Throat lozenges or throat sprays may help as well. 

When treating both mono or strep, it’s important to get plenty of rest and drink lots of fluids.

You can take over-the-counter pain and fever relievers for symptoms that persist. 

The best way to prevent mono or strep is to practice good hygiene. Wash your hands often, and do not share food or drinks with others. 

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When to See a Doctor

If you experience signs of either mono or strep, make an appointment with your doctor to get a proper diagnosis and treatment.

If you see no improvement or worsening of symptoms you should contact your doctor and they can check to see if something else may be affecting your health. 

If you have been diagnosed with mono and you suddenly experience intense pain in the upper left side of your abdomen, it could be a sign of spleen rupture.  Go to the hospital or call 9-1-1.

Frequently Asked Questions

Are mono and strep throat the same thing?
No. Mono is caused by a virus called EBV. Strep throat is a bacterial infection. They often present with similar symptoms, but since one is viral and the other is bacterial, they will require different treatment. Strep throat can be treated with antibiotics.
What does a sore throat from mono feel like?
Unlike strep, a sore throat from mono may develop slowly. The sore throat will get more and more severe as the infection worsens. Due to swelling of the tonsils and lymph nodes, it may be uncomfortable to eat or swallow.
What does mono do to your throat?
In addition to a sore throat, your tonsils may become swollen, and lymph nodes may swell up, too. This can make it uncomfortable to eat or swallow.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.