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]

  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]

• Rigor

  URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. [lutheranhealthcare.org]

• 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]

• Nasal Congestion

  Sore throat and sneezing occur early in the course of the infection and usually Nasal congestion sinus pressure ear pressure are common symptoms and since many contain unnecessary medications that cause unwanted side-effects. [pareja-ideal.eu]

  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]

  The only thing holding me back in that regard is I read that most viral upper respiratory infections include general cold symptoms- nasal congestion, cough, etc. I do not have any of these. [medhelp.org]

  Viral infections are typically accompanied by conjunctivitis, nasal congestion, hoarseness, cough, aphthous ulcers on the soft palate and myalgias. [ncemi.org]

• Dry Cough

  Pareja-Ideal Aja Tonsilremoval Filed Under: pareja-ideal tonsilremoval But a dry Treating Dry Cough While Pregnant:. [pareja-ideal.eu]

• 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]

• 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]

• 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]

• Hunger

  Well Photo Credit Illustration by Celia Jacobs Outrunning Hunger Intense exercise may change the way certain neurons influence our appetite and metabolism. [nytimes.com]

• Neuralgia

  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]

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

  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]

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.