Started to have some discomfort swallowing about 1 1/2 to 2 days later, but no other symptoms.  Went to an ENT on Day 5. I had actually started to feel better on this day but kept the appointment. They observed a red throat and did a throat culture which showed "scant growth of Group C Streptoccus."  Was put on cefdinir 300mg every 12 hours. Started this medication on Day 9 even though I had felt better for several days.

Began to become a little concerned a few days after that when throat became scratchy and developed low grade fever.  Went to urgent care and they observed white spots in throat.  They did a throat culture  and urine test for gonorrhea and chlamydia.  All came back negative. 

The tests were:  

Throat :  APTIMA TECHNOLOGY - TARGET AMPLIFICATION NUCLEIC ACID PROBE TEST TO DETECT AND DIFFERENTIATE RIBOSOMAL RNA.   

Urine:  APTIMA CHLAMYDIA TRACHOMATIS,AMPLIFIED,UR and N.GONORRHOEAE,AMPLIFIED,URINE

My questions are: 

4.  Are there any other tests that you think I should have for total peace of mind?

Sore throat is common after performing oral sex, not caused by STDs. The reasons are unknown. (Gonorrhea sometimes causes sore throat, but most infections cause no symptoms. Chlamydia rarely infects the throat and is not known to cause sore throat.) Group C strep is normal in the throat; I would not have recommended treatment, but this is something you could discuss with the doctor who prescribed it.

As for HIV, it ccould cause sore throat, but not sooner than about 10 days after exposure. Your symptoms cannot possibly be caused by HIV.

1) Yes, cefdinir could affect the gonorrhea test. But it also would cure gonorrhea if you had it. It would have no effect on chlamydia.

2) You quote only the tests that were done, not the results. If they were negative, they are conclusive at 12 days.

3) Genital gonorrhea almost always causes obvious symptoms, with pus dripping from the penis and painful urination. Chlamydia often causes no symptoms. But these things don't matter. If your test results are negative, they prove you were not infected, so no worries.

4) Routine STD testing after potentially risky exposure normally includes blood tests for HIV and syphilis. They are conclusive 6 weeks after exposure. You probably should have these tests for reassurance. However, I stress for reassurance only:  the chance of either infection is almost zero. But better safe than sorry, right?

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

HHH, MD

I also wasn't worried (too much) about syphilis since rates of infection for women is very very low.  

Antibiotics rarely just suppress test results for gonorrhea. If the make the result negative, it's because the infection was cured. Given the timing of your exposure, tests, and treatment, all you can know for certain is you were not infected at the time you were tested. It is theoretically possible you were infected transiently and cured by cefdinir. (This doen't apply to chlamydia, which is not at all affected by cefdinir.) (Correct the drug also is not recommended against gonorrhea. But almost certainly it would be effective.)

The bottom line is that your test results are reliable in shoing you do not now have either gonorrhea or chlamydia.

I have read through several months of questions and answers in order to inform myself.  I have seen it mentioned that oral gonorrhea often clears itself within a month or two and have also seen it mentioned that oral gonorrhea can be tougher to treat than genital gonorrhea.  These two statements seem to contradict each other, but could also be an evolution of opinion so I figured that I would ask for further clarification.

Thank you and Dr. Hook for what you do here.  The opportunity to have access to doctors with your expertise and experience is incredible and your advice reaches many many more than just those who ask the questions. 

All gonorrhea is cleared by the immune system over a few weeks to months; pharyngeal (oral) infection is no different. Older research indicated that most pharyngeal gonorrhea cleared without treatment over 6 weeks; newer studies with improved diagnosis by DNA tersting shows much the same, except that clearing can take as long as 3-4 months.

It is true that pharyngeal gonorrhea is more resistant to treatment than genital or rectal infection, but there's no contradiction between that fact and the duration of untreated infection. However, the standard treatment with ceftriaxone is virtually 100% effective for pharyngeal infection; this is one of the reasons ceftriaxone is preferred over other regimens effective for genital and rectal gonorrhea.

Thanks for the thanks. I'm glad to have helped. Apologies again for this long delayed final reply.