Can Mono Be Mistaken For Strep?
The appearance of fever, sore throat, fatigue, fever, swollen tonsils and swollen lymph nodes are common symptoms in both Strep and Mono. Strep infection is caused by bacteria and Mono infection is caused by virus. The patients presented with these symptoms are given antibiotics for Strep infection. If the symptoms do not subside then the chances of having Mono increases. Antibiotics such as amoxicillin, if it produces rash then it can be a suspected case of Mono. The similar symptoms make it difficult to diagnose immediately whether it is a case of Mono or Strep.
Sore throats are usually not an indication of any severe form of disease. Highly painful sore throat infection requires proper diagnosis to identify the cause. The doctors will perform differential diagnosis for mono or strep throat. Streptococcus is the known culprit to produce symptoms of cold and flu. Children suspected of Strep infection are given antibiotics and the symptoms subside immediately. Strep is commonly seen in children and teenagers. The tonsils are enlarged and have red and white patches in the throat. The complication of Strep infection includes rheumatic fever. Treatment of Strep involves prescription of antibiotics to feel better in a couple of days. The sore throats can cause minor discomfort because of common cold; only a minority of the population suffers from Mono or Strep. Mono is caused by EBV virus and produce symptoms similar to that of cold. The Mono is transmitted by deep kissing and by sharing of glasses and other utensils. There is no treatment required for Mono; the symptoms disappear on its own.
The symptoms of both strep and mono are similar. There will be sore throat, fever, and swollen tonsils and lymph nodes. The children are tested for strep infection and if the tests are negative then the chances of having Mono are higher. The tests which are performed for differential diagnosis are rapid strep test and heterophil antibody test (monospot). Rapid strep test involves culturing of samples for detection for the group A Streptococcus bacteria. Monospot along with Epstein-Barr virus (EBV) titer levels are used for diagnosis of mononucleosis. The tests are performed after Strep infection gets a negative result. If a child returns to the clinic after a positive Strep test and on amoxicillin with a skin rash, then the child is probably suffering from both Strep and Mono infections. Strep Infection which does not get better even after antibiotic treatment should be tested for Mono.
The incubation period for Mono is about 4-6 weeks and for Strep it is 3-5 days. The infections of Strep can be treated and the patient can revert to normal life within a period of 1 week. Mono takes longer time for recovery. The incubation period is long and the symptoms such as fever and sore throat maybe get better in a week’s time but fatigue and swollen lymph nodes takes longtime. Sometimes there will be enlargement of spleen and hence patients suffering from Mono should not perform any rigorous activity. There is no treatment available for Mono; the infection takes its own time of action and also to subside. Sometimes recovery period may take up to 6 months.
Occurrence of both strep and mono at the same time produces ‘synergistic effect’ on a child’s cold and flu-like symptom worsening the situation. According to a study 30% of patients who had been diagnosed with Mono were already suffering from Strep.
Few children do not develop any symptoms of Strep, but they will be carriers of it. The selection of antibiotic in such cases becomes difficult as the choice of antibiotics can result in severe rashes. Strep carriers do not transfer the infection to other people although they test positive for Strep.
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