Oral Gonorrhea Symptoms (cont.)

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How is oral gonorrhea diagnosed?

Definitive diagnosis usually depends on isolating N. gonorrhoeae from the throat; however, most doctors consider a positive rapid throat swab, designed to detect N. gonorrhoeae, a good recommended presumptive diagnosis of the disease. Doctors usually will treat the patient with antibiotics that are effective on the locally occurring N. gonorrhoeae strains. Currently, the CDC recommends the following treatment for gonorrhea: ceftriaxone, 250mg IM plus a single dose of azithromycin, 1 g, orally. Furthermore, if possible, the patient's sex partners from the past 60 days should be evaluated and similarly treated (the CDC terms this Expedited Partner Therapy or EPT).

On the bright side of this disease, many people that develop oral gonorrhea never develop symptoms and spontaneously clear the infection without antibiotics. Those individuals that develop symptoms may also clear the infection, but many are treated with antibiotics. Because a large number of N. gonorrhoeae bacterial strains are resistant to some antibiotics, the treating health care practitioner usually will choose one or more antibiotics that are known to be effective against the strains that are predominant in the patient's local geographic region.

On the darker side of this oral infection, is the rare instance in an immunocompromised individual when the person could develop systemic (throughout the body) spread of the disease.

How can I prevent contracting oral gonorrhea?

Prevention of oral gonorrhea is tricky. The presence of the bacteria on mucus membranes or in discharges in seminal or vaginal fluids facilitates transfer of N. gonorrhoeae bacteria, so preventing contact with these will prevent disease transfer. Condoms, although not 100% effective, afford significant protection from these secretions. This is true for both male and female condoms. The use of condoms during oral sex is not to allow the mouth to come in contact with these secretions, only with the condom material. If you are new to these situations, do not be hesitant to ask for help or instructions from reliable sources (for example, doctors or sex educators) because the information may help protect your health.

Of note, N. gonorrhoeae is not a lonely pathogen. The bacteria frequently are associated with two other organisms, Treponema pallidum (that causes syphilis) and chlamydia trachomatis (that causes chlamydia infections). Most doctors treat the patient with antibiotics that will kill N. gonorrhoeae, but also will kill these other two STD organisms (Treponema, the cause of syphilis and chlamydia) at the same time. Consequently, it is possible (but infrequent) to get infected with all three from one sexual encounter; more often only two are transferred, but doctors rarely know which two, so they treat for all three STD infections.

For uninfected partners, oral sex is relatively safe (except for the occasional gastrointestinal pathogen that may contaminate the genital or anal/rectal areas). For all others, many doctors think that the risks of oral sex outweigh the advantages unless sexual partners agree to protection methods, especially if the partners are new to each other. Even then there is still some risk of accidental infection if the condom or barrier leaks.

For the new kids on the sexual block, don't believe anyone that says oral sex is safe without protection. Protect yourself and your partner(s). If there is any evidence of gonorrhea that you can see (whitish or light yellowish discharge from a partner's penis, vagina, or anal/rectal area), the best choice is not to have oral or any other kind of sex until the person is disease-free. Yep, for first timers and those that might buy or sell oral sex, it might be a good practice to turn on the light and take a look at where your mouth (or any other anatomical part) is headed!

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

REFERENCES:

CDC.gov. Gonorrhea.
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PHOTO: CDC.gov, Public Health Image Library item #3805
<http://phil.cdc.gov/phil/details.asp>


Medically Reviewed by a Doctor on 2/15/2017

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