Oral gonorrhea is a sexually transmitted infection (STI) caused by the Neisseria gonorrhoeae bacterium, which can infect the throat, tonsils, and other areas of the mouth. This infection is transmitted through oral sexual contact. While often asymptomatic, understanding its nature is important for public health.
Does Oral Gonorrhea Resolve on Its Own?
Oral gonorrhea does not resolve on its own without medical intervention. Relying on spontaneous clearance is not a recommended approach. The Neisseria gonorrhoeae bacteria requires specific antibiotic treatment to be eliminated. Even if symptoms are mild or absent, the infection persists and can still be transmitted to others.
Risks of Untreated Oral Gonorrhea
Leaving oral gonorrhea untreated carries several risks, even if symptoms are mild or go unnoticed. The infection can persist, allowing the bacteria to spread to other body parts. This includes potential transmission to areas like the genitals or rectum, either in the infected individual or to sexual partners.
In women, untreated gonorrhea can lead to pelvic inflammatory disease (PID), an infection of the reproductive organs that may result in chronic pelvic pain, ectopic pregnancy, or infertility. In men, it can cause epididymitis, an inflammation of the coiled tube near the testicles, which can also lead to infertility. Although rare, the bacteria can spread through the bloodstream, leading to disseminated gonococcal infection (DGI). DGI can cause symptoms such as joint pain, swelling, skin lesions, or, rarely, affect the heart or brain. Untreated gonorrhea can also increase an individual’s susceptibility to acquiring or transmitting HIV.
Diagnosis and Treatment Approaches
Diagnosing oral gonorrhea involves a throat swab sent to a laboratory for testing. Nucleic Acid Amplification Tests (NAATs) are the most sensitive method for detecting Neisseria gonorrhoeae from throat samples, offering accurate results by identifying the bacteria’s genetic material. While culture tests can also be used, NAATs are preferred due to their higher sensitivity.
Treatment for oral gonorrhea involves specific antibiotic medications. The Centers for Disease Control and Prevention (CDC) recommends a single intramuscular dose of ceftriaxone, 500 mg, as the primary treatment for uncomplicated gonorrhea, including pharyngeal infections. For individuals weighing 150 kg (330 lbs) or more, a 1-gram dose of ceftriaxone is recommended. Previously, azithromycin was given concurrently, but recent guidelines suggest ceftriaxone monotherapy due to antibiotic resistance concerns.
It is important to complete the entire course of prescribed antibiotics, even if symptoms improve, to ensure the infection is fully cleared and to prevent antibiotic resistance. Patients should abstain from sexual activity for at least seven days after completing treatment and until symptoms have resolved. A test-of-cure may be recommended for pharyngeal gonorrhea to confirm the infection has cleared.
Preventing Oral Gonorrhea
Preventing oral gonorrhea relies on safer sexual practices and open communication. Consistent and correct use of barrier methods during oral sex significantly reduces transmission risk. This includes using condoms on the penis or dental dams over the vulva or anus. Dental dams, thin sheets of latex or polyurethane, act as a barrier to prevent bodily fluid exchange during oral-vaginal or oral-anal contact.
Openly discussing STI status and testing history with sexual partners is an important prevention step. Regular STI testing is also recommended, especially for sexually active individuals or those with new or multiple partners, as oral gonorrhea presents without symptoms. Early detection through testing allows for prompt treatment, preventing further transmission and complications. Limiting the number of sexual partners can also help reduce the overall risk of acquiring STIs.