Sore Throat

[seattle_guy]

I'm a male who has suffered occasionally from recurrent NGU for years.

Nine days ago I had mutual oral sex with a new partner, another man. Within a day or so I felt a very slight sore throat. After two days I noticed a milky penile discharge. When tested I was told there were no gonococcal cells visible, just NGU. I am still waiting for blood and urine test results. I was given Doxycycline. The discharge has pretty much cleared up, but the sore throat is quite a bit worse. Today I noticed small white patches at the back of my throat.

I'm concerned about my throat symptoms, which are quite painful. Could they be due to an STD?

[H. Hunter Handsfield, M.D.]

Sore throat is not a common STD symptom, but could be gonorrhea--the most common STD acquired by performing fellatio.  Herpes is theoretically possible, but usually is associated not only with sore throat, but with obvious open ulcers in the mouth and throat.

However, for 30 years it has been known that people who perform oral sex on men have an increased frequency of sore throats in the next few days.  Typically no STD is found and the cause is unknown.  Speculation has been on minor trauma, physical irritation (e.g., from semen?), and anxiety.

You first describe the sore throat as mile, then "quite painful".  You should see a provider, and also ask your partner to get examined for STDs.  While you're at it, you probably should address HIV risks.  The chance of HIV is low from performing fellatio, but not zero.  You should have asked and shared HIV status with your partner before the exposure; perhaps you did that.

Good luck---  HHH, MD

[H. Hunter Handsfield, M.D.]

I forgot to say that the sore throat and your recurrent NGU are probably not connected in any way.  Most likely the NGU is just a recurrence of your previous problem, not a new infection; and even if new, it is unlikely the same problem is affecting your throat.

[seattle_guy]

Thanks Doctor. In those cases where sore throat IS due to gonorrhea, what specific symptoms typically show up? Is it usually just a common-cold-type of feeling? Or is it more focused and painful?

[H. Hunter Handsfield, M.D.]

Just about every cause of sore throat that exists causes the identical spectrum of severity and symptoms.  The specific details have no value in predicting the cause, whether a cold virus, gonorrhea, strep, or anything else.

95% of throat gonorrhea cases are entirely asymptomatic.

[raylaramie]

A related discussion, STDs from kissing was started.