An infection of the throat involving the tonsils and the larynx (pharynx) caused by a bacteria, Neisseria gonorrhoeae .

Alternative Names

Gonococcal pharyngitis

Causes, incidence, and risk factors

Gonococcal pharyngitis is a sexually-transmitted disease. It is acquired through oral sex with an infected partner. The majority of throat infections caused by gonococci have no symptoms ( asymptomatic ). When discomfort is present, it is generally mild. Symptoms involving the rest of the body normally are not present unless the person develops disseminated gonococcemia (wide-spread infection throughout the bloodstream). Untreated gonorrhea may spread to other parts of the body, causing inflammation of the testes or prostate in men or pelvic inflammatory disease in women. Gonococci in the throat are present in 10 to 20% of women who have gonorrhea. In homosexual men with gonorrhea, pharyngeal (throat) infection is present in 10 to 25%. Risk factors include recent exposure to gonorrhea, sexual activity with multiple partners, male homosexuality, and performing oral sex. Almost 360,000 cases of gonorrhea were reported to the Centers for Disease Control in 2000. The incidence has remained steady for several years at 1 case per 1000 people.

Signs and tests

A throat swab culture is positive for gonococcus. Note that standard strep throat testing will not pick up gonorrhea. If you think you might have gonococcal pharyngitis, you should tell your health care provider.

Treatment

There are two aspects of treating a sexually transmitted disease, especially one as easily spread as gonorrhea . The first aspect is to cure the affected person. The second is to locate and test all of the other sexual contacts and to treat them to prevent further spread of the disease. That is why mandatory reporting has been instituted and has, until recently, held the number of cases of gonorrhea at a low level. However, the incidence is once again rising. Beginning about the time of the Vietnam War, the United States saw the appearance of penicillin- and tetracycline-resistant strains of gonorrhea. Resistant strains have been increasing over the last few years. Because of this, a new standardized treatment regimen has now been recommended by the Centers for Disease control (CDC). Instead of the standard penicillin treatment, gonorrhea is now treated with newer antibiotics. This treatment regimen includes any one of the following antibiotics.

INJECTIONS

Ceftriaxone IM (injected into a muscle)

Spectinomycin IM (injected into a muscle)

ORAL (by mouth) one-time dose

Cefixime

Ciprofloxacin

Ofloxacin

Cefuroxime Axetil

Cefpodoxime proxetil

Enoxacin

ORAL (by mouth) multiple dose

Erythromycin

In addition to treatment for gonorrhea, patients are usually treated at the same time for chlamydia. This can be harder to diagnose ,but can sometimes be found to cause infection at the same time. A follow-up visit 7 days after treatment to recheck cultures and confirm the cure of infection is important.

Expectations (prognosis)

Gonorrhea can be completely and quickly cured when diagnosed early and treated promptly before complications develop.

Complications

BOTH SEXES

disseminated gonococcemia

gonococcal arthritis

MALE

urethral scarring and stricture

epididymitis

orchitis

prostatitis

FEMALE

pelvic inflammatory disease

salpingitis

perihepatitis

infertility

sterility

increased

incidence of tubal pregnancy ( ectopic pregnancy )

Calling your health care provider

Call your health care provider if you have had a known or suspected contact with an infected sexual partner. Call your health care provider if you develop symptoms of gonococcal pharyngitis.

Prevention

Abstinence is an absolute answer to preventing gonorrhea , but this is often neither practical, nor reasonable. Safer sex behaviors can reduce risk. The use of condoms , both male and female types, markedly decreases the likelihood of contracting a sexually transmitted disease -- but they must be used properly. The condom should be in place from the beginning to end of sexual activity, and should be used EVERY time the person engages in sexual activity, including oral sex, with a non-monogamous partner or potentially infected partner. Condoms are inexpensive, especially considering the potential consequences of contracting a sexually transmitted disease. Treatment of all sexual partners is essential to prevent re-infection.