Oral and Pharyngeal Involvement with Neisseria gonorrhoeae

 

Risk factors:

(1) oral sex

(2) HIV or other cause of immunodeficiency

(3) gonorrhea and/or other sexually transmitted disease (STD) diagnosed in sexual partner

 

Sites of infection:

(1) gingivitis

(2) stomatitis

(3) pharyngitis

(4) tonsillitis

 

Reasons for failure to diagnose:

(1) failure to collect and culture for Neisseria

(2) small numbers of organisms

(3) failure to consider the diagnosis

 

When to suspect:

(1) sexually active with risk factors present

(2) Gram-negative diplococci seen in Gram stain

 

Molecular techniques such as PCR are more sensitive than culture for detecting the organism but the method must be approved for the mouth or pharynx.

 

If oral or pharyngeal gonorrhea is identified, then syphilis or other STD organisms may also be present.