Three Cases of Gonococcal Pharyngitis

Three cases of gonococcal pharyngitis were presented. The patients were all female and the partners of male patients with gonococcal urethritis. Neisseria gonorrhoeae was isolated using selective media both from the cervix and pharynx of all three cases. Pharyngeal sympotms were obscure and all patients were brought to our clinic passively for epidemiological treatment. Spectinomycin MIC of three isolates were 12.5g/ml that suggest the isolates were sensitive to Spectinomycin clinically. Though after one shot treatment with Spectinimycin 2gim, N. gono. were eradicated from the cevix, but were not eradicated from the pharynx of the same patients in three cases. Epidemiological studies in our clinic revealed that 5-10% of male gonococcal urethritis were not infected by genital intercourse but by fellatio. Pharyngeal gonorrhea is at present an important source of gonococcal transmission because of both its latency and its unresponsiveness to the treatment effective for genital gonorrhea.The report of pharyngeal gonorrhea has been sparce in Japan. The presence of pharyngeal gonorrhea is masked by both blind use of broad spectrum antibiotis and difficulty of gonococcal isolation from the pharynx due to lack of opportunity to culture throat swabs on selective media for N. gono. Special characteristics and epidemiological importance of pharyngeal gonorrhea were stressed. EIA detection of gonococcal antigen (Gonozyme) is not applicable to throat swab due to the cross reactivity of Gonozyme to normal habitant of pharynx.