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].

• 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]

• Nasal Discharge

  You may also experience nasal discharge and congestion, which might lead you to think that you merely have a cold. [healtharticles101.com]

  Difficulty swallowing Fever Sore throat Tender, swollen lymph nodes in the neck Additional symptoms that may be associated with this disease: Abnormal sense of taste Headache Joint stiffness Muscle pain Nasal congestion Nasal discharge Neck pain Note: [lutheranhealthcare.org]

  There is mild clear nasal discharge with no sinus tenderness. Her symptoms may be worse at night early in the morning and after running or She may also have a sore throat a sour taste in her mouth or vomiting. [pareja-ideal.eu]

  discharge, rather than by oral contact. 7, 8 Symptoms develop after a short incubation period of 24 to 72 hours. [aafp.org]

• 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]

• Joint Stiffness

  Difficulty swallowing Fever Sore throat Tender, swollen lymph nodes in the neck Additional symptoms that may be associated with this disease: Abnormal sense of taste Headache Joint stiffness Muscle pain Nasal congestion Nasal discharge Neck pain Note: [lutheranhealthcare.org]

• Behavior Disorder

  Covers new approaches to diagnostic imaging and genetic testing, new diagnostic guidelines, BRUE (brief resolved unexplained event), stroke in children, behavior disorders, syncope, recurrent fever syndromes, and much more. [books.google.com]

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.

• Positive Throat Culture

  Gonococcal pharyngitis is diagnosed by a positive culture (Thayer-Martin medium) for Neisseria gonorrhoeae. [aafp.org]

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]

Treatment advice Reduced susceptibility to the first line treatment of IMI Ceftriaxone and Azithromycin is emerging in urban Australia. [sti.guidelines.org.au]

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]

[…] of treatment ( 1 ). [cdc.gov]

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]

Hoarseness, in the setting of cough or coryza, suggests a viral etiology. [cdemcurriculum.com]

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]

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 ) Men [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]

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]

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]

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]

/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]

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]

Treatment of all sexual partners is essential to prevent re-infection. Centers for Disease Control and Prevention (CDC). [lutheranhealthcare.org]

External resources CDC National Prevention Information Network (NPIN) National Center for HIV, STD and TB Prevention P.O. [drugs.com]

Additional Info CDC National Prevention Information Network (NPIN) National Center for HIV, STD and TB Prevention P.O. [womenshealthmag.com]

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.