[Question #11135] Oral Gonorrhea

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16 months ago
Hello Doctors. I first want to say thank you for this website. It is insanely informative and direct, which can't be said about the internet. Last week I started to come down with a cold. I made the mistake of trying MSM oral on Thursday with a guy on Reddit. I didn't enjoy it and only did it for maybe 5 minutes. I saw no sign of infection on the other party. I did ask the other party before we met if he has been tested. He stated that he was tested 3 months prior. I also asked him two times before committing to the act as I was quite paranoid. After that was done, I went home and rinsed my mouth and gargled with Listerine as I wasn't feeling the best. 

I have done a lot of reading on this site and I understand that nothing is guaranteed and oral gonorrhea is less common than genital gonorrhea. It is also less worrisome knowing that the individual confirmed he had tested & showed no signs of infection as I understanding asymptomatic genital gonorrhea in males is rare. On Friday, the very next day, I was prescribed amox-clav 875/125 (augmentin) as I was believed to have a sinus infection. I understand that this is not the preferred treatment for oral gonorrhea, but reading on other forums it's possible this would have aborted gonorrhea. From my understanding, this would have completely aborted syphilis which I am not concerned about. My biggest concern is oral gonorrhea. Yesterday, I went to the doctors to get swabbed for strep/covid/flu etc. I asked my doctor about getting swabbed for oral gonorrhea and she declined for me to do so. She stated that she see's no reason to and see's no sign of infection. She stated that if I feel under the weather in two weeks then I should consider it then. She also stated that she's only seen oral gonorrhea a few times and seems to be less common than what is portrayed online.
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16 months ago
She also  stated that augmentin would have not aborted the STI as it is not the recommended treatment; however, she said it was encouraging that it assisted with the sore throat. My questions are:

1) Is this something I should even be worried about considering what I have explained?
2) I do not give oral to my wife nor do we really deep kiss, if I did have it - should I be worried about her getting it and then somehow transmitting it to my genitals? 
3) I read back and forth on oral gonorrhea going away on it's own. It seems like the last study on this was done in the 1970's when gonorrhea was most likely less resistant to antibiotics. I also asked my doctor about this. She stated that oral gonorrhea would not go away on it's own and would require treatment. Can you confirm if this is actually true? 
4) Did augmentin help in anyway? 

I really appreciate the expertise! 
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16 months ago
I also want to preface and say that I was filing under the weather before committing the act. 
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H. Hunter Handsfield, MD
16 months ago
Welcome to the forum. Thank you for your kind words about it and for your confidence in our services.

I agree with your doctor that there is no point in testing you for oral gonorrhea. Her reasoning is wrong:  oral gonorrhea rarely causes sore throat or other symptoms, therefore waiting for symptoms is nonsense. However, there is no possibility you have it, for several reasons. First, you are correct that your partner having no symptoms to suggest urethral (penile) gonorrhea is strong evidence he didn't have it, especially since he had recently been tested. Second, if you had been infected, indeed the augmentin treatment would have cured it. Your doctor is correct that augmentin is not a recommended treatment, but taking several doses over a few days certainly would be 100% effective in curing it. (It also would have aborted syphilis if you had been exposed.) For those reasons, at this point there is definitely no need to test for either oral gonorrhea or syphilis; you can be certain you have neither one.

Those comments pretty well cover your numbered questions, but to be explicit:

1) No, you should not be worried at all.

2) This is irrelevant since there is no chance you have it. But even if you had oral gonorrhea, there is no way you wife could have it acquired it. (Even performing oral sex or deep kissing, if those were your usual sexual practices, would not likely have infected her.)

3) Here is more evidence your doctor is not up to speed on gonorrhea. Oral gonorrhea almost always is cleared by the immune system within a few weeks, even without antibiotic treatment. But this too is irrelevant, since you did have effective treatment.

4) Augmentin would have cured oral gonorrhea if you had acquired it.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD
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16 months ago
You’re absolutely fantastic Doctor Handsfield. I truly admire your work and this platform that you created. No further questions. I lay the anxious thoughts to rest. Thank you again & have a great weekend. 
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H. Hunter Handsfield, MD
16 months ago
Thanks for the thanks. I'm glad to have helped.---