Gonococcal pharyngitis is a sexually transmitted infection of the tonsils and back of the throat (pharynx).

Gonococcal pharyngitis is caused by Neisseria gonorrhoeae bacteria. The bacteria spreads through oral sex with an infected partner. Most of these throat infections produce no symptoms (asymptomatic).

When there is discomfort, it is usually mild. There aren't any symptoms in the rest of the body unless the person develops disseminated gonococcemia, where the infection spreads throughout the body through the bloodstream.

This disease is most common in men who have sex with men. Risk factors include recent exposure to gonorrhea, sexual activity with multiple partners, and performing oral sex.

• Difficulty swallowing
• Fever
• Sore throat
• Tender, swollen lymph nodes in the neck

• Abnormal sense of taste
• Headache
• Joint stiffness
• Muscle pain
• Nasal congestion
• Nasal discharge
• Neck pain

Note: There may be no symptoms.

A throat swab culture is positive for gonococcus bacteria. Regular strep throat testing will not pick up gonorrhea. If you think you might have gonococcal pharyngitis, you should tell your health care provider. Telling your provider means they will ask for a special test to see if you have this disease.

There are two parts to successfully treating a sexually transmitted disease, especially one as easily spread as gonorrhea. The first is to cure the infected person. The second is to locate, test, and treat all of that person's sexual contacts to prevent further spread of the disease.

Mandatory reporting of gonococcal disease has been instituted and has kept the number of cases of gonorrhea at a low level. However, the number of cases is rising, especially among men who have sex with men in large urban centers.

The bacteria that causes this disease has become resistant to certain drugs. Today, ceftriaxone injected into a muscle is the only antibiotic used to treat gonococcal pharyngitis.

People who are allergic to penicillin and cephalosporin may be prescribed azithromycin, which is taken by mouth.

In addition to treatment for gonorrhea, people are usually treated at the same time for chlamydia. Chlamydia often causes infection at the same time as gonorrhea, but it can be harder to diagnose.

Gonorrhea can be completely and quickly cured when diagnosed early and treated promptly before complications develop. Untreated gonorrhea may spread to other parts of the body, causing inflammation of the testes or prostate in men, or pelvic inflammatory disease in women.

The following complications may occur in both men and women:

• Disseminated gonococcemia
• Gonococcal arthritis

Complications in men may include:

• Epididymitis
• Orchitis
• Prostatitis
• Urethral scarring and stricture

Complications in women may include:

• Increased chances of ectopic pregnancy
• Infertility
• Perihepatitis
• Pelvic inflammatory disease
• Salpingitis
• Sterility

Call your health care provider if you know or suspect that your sexual partner may be infected.

Call your health care provider if you develop symptoms of gonococcal pharyngitis.

Sexual abstinence is the only sure way to avoid gonorrhea, but this is often neither practical nor reasonable. Safer sex behaviors can reduce your risk. The use of condoms, both male and female types, decreases the likelihood of contracting a sexually transmitted disease -- but they must be used properly.

The condom should be in place from the beginning to end of sexual activity, and should be used EVERY time the person engages in sexual activity -- including oral sex -- with a non-monogamous partner or possibly infected partner.

Treatment of all sexual partners is essential to prevent re-infection.

Centers for Disease Control and Prevention (CDC). 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. 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.