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Gonococcal Pharyngitis

Gonococcal pharyngitis is a mild and localized type of infection caused by Neisseria gonorrhoeae, a gram-negative bacterial pathogen. Many patients are asymptomatic, and receptive oral sex is the predominant route of bacterial acquisition. The diagnosis can rarely be made based on clinical criteria, which is why a thorough patient history and appropriate microbiological studies are necessary.


Presentation

Gonorrhea, after chlamydia infection, is the most common sexually transmitted disease (STD) worldwide, and various clinical presentations are described in the literature [1] [2] [3] [4]. One of them is gonococcal pharyngitis, developing after transmission of bacteria through receptive oral intercourse, more commonly during fellatio than cunnilingus [2] [3] [5]. It is seen in approximately 3-7% of heterosexual males and in 10-25% of heterosexual women and men who are having sex with men (MSM) who already suffer from gonorrhea, and the clinical course is asymptomatic in up to 90% of cases [1] [2] [3] [4]. Conversely, signs of acute pharyngitis or tonsillitis (fever, erythema of the throat and cervical lymphadenopathy) developing 3-4 days after acquisition of bacteria are encountered in symptomatic cases [1] [2]. Many patients simultaneously suffer from a genital gonorrhea infection, thus localized genital symptoms apart from pharyngeal complaints (if they appear) are often present [2] [4]. Although spontaneous resolution is seen in virtually all individuals, the diagnosis is not made in up to 26% of adolescent women, which is why many studies have advocated screening for gonococcal pharyngitis in patients who already exhibit some other type of infection [2] [4].

Prostitute
  • It is especially common in the tropics, where the prevalence is high in prostitutes, who transmit it to migrant male workers.[histopathology-india.net]
  • Illustration by Chad Hagen In January, 2009, a thirty-one-year-old prostitute visited a clinic in Kyoto, Japan, for a routine checkup.[newyorker.com]
  • Risk Factors for Gonococcal Infections Adults Age younger than 25 years Black race History of gonococcal infection or other STIs Inconsistent condom use Men who have sex with men New or multiple sex partners Prostitution Substance abuse Children Mothers[aafp.org]
  • While it is primarily spread by exposure to infected blood, such as from sharing needles for drug use, piercing, tattooing, and occasionally sharing nasal straws for cocaine use, people who have sex with prostitutes are at a increased risk for Hepatitis[emedicinehealth.com]
Hunting
  • In most cases, you cannot prevent illness, germs and other microscopic beasties that have no problem hunting you down or hopping from person to person at a cocktail party. However, this is one sore throat that you absolutely can avoid.[healtharticles101.com]
Bleeding Gums
  • It happens that the disease is accompanied by bleeding gums and unpleasant mouth odor. The overall clinical picture gonococcal pharyngitis similar to other types of the disease.[respiratory.vsebolezni.com]
Toothache
  • Here’s what you need to know about a white tongue black spots and A rosy tongue can sometimes go hand-in-hand with a sore throat. 1) The relief of headache toothache migraine neuralgia sore throat dysmenorrhoea.[pareja-ideal.eu]
Palpitations
  • When a virus such as Epstein-Barr is active in the body it often gives off damaging Sore throat canker sores heart palpitations stagnant liver sluggish liver cancer chronic UTIs lipomas allergies hot spots teeth issues bad eath.[pareja-ideal.eu]
Migratory Polyarthritis
  • To further characterize this clinical picture the features of six patients presenting with the migratory polyarthritis of acute rheumatic fever have been analyzed.[ncbi.nlm.nih.gov]

Workup

The diagnosis of a gonococcal pharyngitis may be difficult to make, as signs and symptoms are frequently absent. For this reason, physicians must be meticulous when examining patients with a possible diagnosis of an STD. Firstly, a detailed history should be obtained, with an emphasis on sexual activity and "risky" exposure, but also if any other symptoms (for example, genital or systemic signs of infection) are present. The importance of a properly obtained patient history lies in the fact that findings from physical examination are almost always normal, or point to a non-specific pharyngitis comprised of cervical lymphadenopathy and erythema. Thus, if adequate clinical suspicion exists, microbiological investigations should be carried out. In the setting of gonococcal pharyngitis, gram staining of the pharyngeal swab is one of the most widely used methods to detect N. gonorrhea, and the test is advised in all human immunodeficiency virus (HIV) positive individuals, particularly men who are having sex with men (MSM) [3] [5] [6]. Also, cultivation of swab samples has been regarded as a potential diagnostic method [3] [5] [6]. However, the asymptomatic nature of gonocococal pharyngitis and frequent coinfection of other organs and tissues has disputed the role of routine testing in clinical practice [3]. Nevertheless, all patients in whom symptoms of pharyngitis develops shortly after receptive oral sex should undergo testing for gonococcal pharyngitis, primarily because it is an important source of further spread.

Neisseria Gonorrhoeae
  • Gonococcal pharyngitis is a mild and localized type of infection caused by Neisseria gonorrhoeae, a gram-negative bacterial pathogen. Many patients are asymptomatic, and receptive oral sex is the predominant route of bacterial acquisition.[symptoma.com]
  • Neisseria gonorrhoeae. In: Cohen J, Powderly WG, Berkley SF, Calandra T, Clumeck N, Finch RG, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, PA; Churchill Livingstone Elsevier; 2005: chap 209.[lutheranhealthcare.org]
  • Neisseria gonorrhoeae may disseminate from mucosal surfaces via the bloodstream and produce arthriti... FIGURE 2-10.[5minuteconsult.com]
  • The etiologic agent, NEISSERIA GONORRHOEAE, was isolated by Neisser in 1879. Definition (CSP) acute infectious disease characterized by primary invasion of the urogenital tract; the etiologic agent is Neisseria gonorrhoeae.[fpnotebook.com]
Positive Throat Culture
  • throat culture for GABHS in a population of adults and children. 26 [Evidence level B, observational study] The findings were tonsillar exudates, anterior cervical lymphadenopathy, absence of cough, and history of fever higher than 38 C (100.4 F).[aafp.org]

Treatment

  • In the absence of timely treatment the patient complications can occur. In addition to the primary treatment, the patient is required to comply with regulations regarding the supply. All food must undergo thorough heat treatment.[respiratory.vsebolezni.com]
  • Update to CDC's sexually transmitted diseases treatment guidelines, 2006: fluoroquinolones no longer recommended for treatment of gonococcal infections. MMWR Morb Mortal Wkly Rep . 2007;56:332-336. Handsfield HH, Sparling PF. Neisseria gonorrhoeae.[lutheranhealthcare.org]
  • A book dealing with current trends in the diagnosis and treatment of sexual diseases can, by nature of the task, be neither encyclopedic nor all-encompassing.[books.google.com]
  • Antibiotic treatment is not effective against viruses which cause about half.[pareja-ideal.eu]
  • She is co-editor of Women and Health, a comprehensive reference textbook for researchers, teaching faculty, and clinicians on the role of gender in understanding disease occurrence, diagnosis, treatment, and priority-setting in health care. Dr.[books.google.com]

Prognosis

  • Prognosis If gonorrhea infections are diagnosed and treated quickly and correctly, recovery usually is complete unless pelvic inflammatory disease (PID) develops. PID is more likely to develop if treatment is delayed.[womenshealthmag.com]
  • Outlook (Prognosis) A gonorrhea infection that has not spread can almost always be cured with antibiotics. Gonorrhea that has spread is a more serious infection. Most of the time, it gets better with treatment.[nicklauschildrens.org]

Etiology

  • Her research has focused on the hormonal etiologies of reproductive cancers and the role of maternal, gestational, neonatal and early life factors in breast cancer risk, including endocrine disruptors such as diethylstilbestrol, a drug previously given[books.google.com]
  • Hoarseness, in the setting of cough or coryza, suggests a viral etiology.[cdemcurriculum.com]
  • The etiologic agent, NEISSERIA GONORRHOEAE, was isolated by Neisser in 1879. Definition (CSP) acute infectious disease characterized by primary invasion of the urogenital tract; the etiologic agent is Neisseria gonorrhoeae.[fpnotebook.com]
  • Etiology Pathogen Neisseria gonorrhoeae ( N. gonorrhoeae , gonococcus ) Gram-negative , intracellular , aerobic, diplococci Transmission Risk factors Multiple sexual partners Low socioeconomic status Lack of barrier protection (e.g., condomless sex )[amboss.com]
  • GONOCOCCAL INFECTIONS Etiology Caused by Neisseria gonorrhoeae. Epidemiology Since 1997, there has been a gradual but steady increase in reported cases of gonococcal infection.[canada.ca]

Epidemiology

  • Troisi is a cancer epidemiologist in the Division of Cancer Epidemiology and Genetics, at the National Institutes of Health’s Cancer Institute and an associate member of the Norris Cotton Cancer Center at Dartmouth College..[books.google.com]
  • Epidemiology References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Epidemiology Gonococcal infection is the second most common bacterial disease in the United States that is classified as a reportable and notifiable infection.[pedsinreview.aappublications.org]
  • Epidemiology Since 1997, there has been a gradual but steady increase in reported cases of gonococcal infection. Most affected are males 20–24 years of age and females 15–19 years of age.[canada.ca]
  • Introduction Classification Neisseria Gram-negative diplococci often intracellular within neutrophils Epidemiology incidence the second most common bacterial sexually-transmitted infection after Chlamydia location genital tract risk factors unprotected[medbullets.com]
Sex distribution
Age distribution

Pathophysiology

  • Review Date: 5/19/2008 Reviewed By: Linda Vorvick, MD, Seattle Site Coordinator, Maternal & Child Health Lecturer, Pathophysiology, MEDEX Northwest Division of Physician Assistant Studies, University of Washington School of Medicine; Jatin M.[lutheranhealthcare.org]
  • Pathophysiology Gonococcal infections tend to be associated with the acute onset of symptoms and purulent mucosal drainage due to the organism's ability to recruit polymorphonuclear leukocytes (PMNs).[pedsinreview.aappublications.org]
  • Advances in anesthetic and surgical techniques, an improved understanding of the pathophysiology of pain, the development of new opioid and […] Read More Weak And Strong Opioids May 4, 2018 Medical library WEAK OPIOIDS A collection of medications that[medicallibraryonline.com]

Prevention

  • She is also active in several large studies of women's health, including the Nurses' Health Study, the Kronos Early Estrogen Prevention Study, and the Women's Health Initiative.[books.google.com]
  • Avoidable - 0% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 100% Also called[medicbind.com]
  • Treatment of all sexual partners is essential to prevent re-infection. Centers for Disease Control and Prevention (CDC).[lutheranhealthcare.org]
  • In most cases, you cannot prevent illness, germs and other microscopic beasties that have no problem hunting you down or hopping from person to person at a cocktail party. However, this is one sore throat that you absolutely can avoid.[healtharticles101.com]
  • This disease can cause serious complications, so it is recommended to use all possible means to prevent its development. The causative agent of the disease is the same, from which there is gonorrhea, so if any sexual contact must use a condom.[respiratory.vsebolezni.com]

References

Article

  1. Shim BS. Current Concepts in Bacterial Sexually Transmitted Diseases. Korean Journal of Urology. 2011;52(9):589-597.
  2. Mayor MT, Roett MA, Uduhiri KA. Diagnosis and management of gonococcal infections. Am Fam Physician. 2012;86(10):931-938.
  3. Mandell GL, Bennett JE, Dolin R. Mandel, Douglas and Bennett's Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, Pennsylvania: Churchill Livingstone; 2015.
  4. Kasper DL, Fauci AS, Hauser SL, Longo DL, Jameson J, Loscalzo J. eds. Harrison's Principles of Internal Medicine, 19e. New York, NY: McGraw-Hill; 2016.
  5. Ng L-K, Martin IE. The laboratory diagnosis of Neisseria gonorrhoeae. Can J Infect Dis Med Microbiol. 2005;16(1):15-25.
  6. Murray PR, Rosenthal KS, Pfaller MA. Medical Microbiology. Seventh edition. Philadelphia: Elsevier/Saunders; 2013.

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Last updated: 2018-06-22 00:27