From the Guidelines
Yes, you can have oral chlamydia or gonorrhea without experiencing pharyngitis (sore throat). These sexually transmitted infections can be present in the throat without causing noticeable symptoms in many cases. When asymptomatic, people can unknowingly carry and transmit these infections to partners through oral sex. According to the Centers for Disease Control and Prevention guidelines from 1993 1, chlamydia has not been established as a cause of pharyngitis, even though it can be detected in the pharynx after inoculation from oral-genital exposure.
Key Points to Consider
- If you've engaged in unprotected oral sex and are concerned about potential exposure, testing is recommended even without symptoms.
- Testing typically involves a simple throat swab.
- If positive, treatment for oral chlamydia usually consists of azithromycin (1 gram taken once) or doxycycline (100mg twice daily for 7 days), as recommended by the U.S. Centers for Disease Control and Prevention guidelines 1.
- For oral gonorrhea, treatment typically includes ceftriaxone (500mg as a single intramuscular injection), as suggested by the 2006 guidelines for the treatment of sexually transmitted diseases 1.
- It's essential to complete the full course of antibiotics even if you feel fine and to abstain from sexual activity until treatment is complete and partners have been treated.
- The asymptomatic nature of these infections is why regular STI screening is crucial for sexually active individuals, especially those with multiple partners.
From the Research
Oral Chlamydia and Gonorrhea Infection
- It is possible to have oral chlamydia or gonorrhea without having pharyngitis, as many infections with these pathogens can be asymptomatic or associated with few symptoms 2.
- Approximately 53% to 100% of extragenital gonorrhea and chlamydia infections are asymptomatic or associated with few symptoms, which includes oral infections 2.
Diagnosis and Treatment
- Nucleic acid amplification tests have high sensitivities and specificities for the diagnosis of gonorrhea and chlamydia, including oral infections 2.
- The recommended treatment for uncomplicated gonorrhea, including oral infections, is a single 500 mg IM dose of ceftriaxone, and if chlamydial infection has not been excluded, concurrent treatment with doxycycline is recommended 3, 4.
Antimicrobial Resistance
- Antimicrobial resistance is a major public health concern, and the treatment of gonorrhea and chlamydia is complicated by the development of resistance to first-line therapies 3, 4.
- The rise in resistance to azithromycin has led to changes in treatment recommendations, with ceftriaxone now being the preferred treatment for gonorrhea 3, 4.