Clinical Spectrum of Pharyngeal Gonococcal Infection

Abstract

Neisseria gonorrhoeae was isolated on selective medium from the pharynx of 150 patients, including 125 examined during a nine-month prospective study. The prevalence of neisseria species in 2,224 patients at a venereal-disease clinic was N. meningitidis, 17.2 per cent, N. gonorrhoeae, 5.6 per cent, and N. lactamicus, 1.9 per cent. Among patients with gonorrhea, gonococcal pharyngeal infection was found in 20.9 per cent of homosexual men, 10.3 per cent of women, and only 3.2 per cent of heterosexual men. Gonococcal pharyngeal infection was correlated with the practice of fellatio (p less than 0.001), and 4.2 per cent of patients who practiced fellatio had infection of the pharynx alone. Symptoms of pharyngitis were also correlated with practice of fellatio (p less than 0.0001), but not with gonococcal pharyngeal infection. However, N. gonorrhoeae did appear responsible for pharyngitis in selected patients, and pharyngeal gonococcal infection was the only apparent source of disseminated gonococcal infection in five patients. Procaine penicillin G and tetracycline regimens were effective in treatment of pharyngeal gonococcal infection, but spectinomycin was not.