[Question #2797] Oral Gonorrhea

40 months ago
Hello,

I am a 28 year old, sexually active, homosexual male.  I also have Crohn's disease and Generalized Anxiety Disorder.  I am currently in a FWB situation in which me and another man occasionally hook up.  It is always protected but last Friday (Sept 29th) I performed oral sex and did not swallow, but some may have got into my mouth.  Two days later (Sunday Oct 1) I developed a sore throat which is finally going away today (Wed Oct 4th).  I also have ringing in my ears, headache, and general sinusitis symptoms.  I get frequent sinusitis due to my Crohn's.  However, due to the timing, my anxiety is causing me to wonder if this could be oral gonorrhea.  I went to my PCP yesterday and tested negative for strep but was told it looks like a typical sinus infection and was prescribed Augmentin.  I went to a testing facility today to get tested but was told it was too early to test as gonorrhea or chlamydia wouldn't test positive until two weeks after the encounter and that I should come back then.  I have not started the Augmentin yet in case it would negatively effect any possible STIs but want to treat my sinusitis if that is all it is.  My question is, is there a legitimate concern for STI in this case or is my anxiety getting the best of me?  Seeing as how I can't test for two weeks I wanted to reach out to an expert to help assuage my anxiety.  I also was unsure if it is oral gonorrhea since I am having typical sinusitis symptoms that I could not find were common with oral gonorrhea.  My FWB stated that they tested negative for everything several months ago but I am unaware if they have had other partners in the meantime.  Thank you.
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Welcome to the forum. Thanks for your question.

On one hand, oral sex with another male clearly carries risk for pharyngeal (throat) infection with gonorrhea. OTOH, if your friend did not have an obvious discharge of pus from the penis, the chance he had gonorrhea is very low:  asymptomatic urethral infection occurs but is rare. Also, pharyngeal gonorrhea rarely causes symptoms:  90-95% of infected men have absolutely no sore throat or other symptoms. Also, your research about gonorrhea and "sinus symptoms" is exactly right: gonorrhea is not known to cause such symptoms, i.e. nasal congestion, drip, or cough. It is much more likely you have a garden variety cold or other upper respiratory virus.  Because it's a virus, Augmentin probably won't help (and most doctors are learning that they should not prescribe antibiotics in situations like this). In any case, if you did have pharyngeal gonorrhea, almost certainly the Augmentin would cure it. In other words, this probably never was a significant possibility, and at this point for sure yoiu needn't worry about it.

Your doctor obviously is not up to speed on STDs, testing for them, etc (or you misunderstood -- but I doubt you did). Throat swab testing for gonorrhea is valid any time more than 3-4 days after exposure, maybe even sooner than that. It certainly is not necessary to wait two weeks -- rank nonsense!

At this point, I suggest you just let this go. Don't worry about testing for gonorrhea or anything else. All is well.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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40 months ago
Dr. Handsfield,

Thank you very much for your reply.  I'm glad to know I was just overreacting to an ill-timed viral infection!  Yes,  I was very confused when I went to the testing center and they told me to come back in two weeks as testing would not be able to accurate until that time, especially when I told them my concern was oral and wanted a swab test.  

Thank you very much again for your reply and I can sleep a little easier tonight!
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
40 months ago
Thanks for the thanks. I'm glad to have helped.

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