Gonorrhoeae of throat

[ford12]

I had unprotected oral and vaginal sex with unknown women. The following day I had vaginal sex with my wife and 3 days later I rec'd oral sex from her. About 2 days after oral sex she went to Dr. with a sore throat. I looked at throat and it was 2 red bumps with white center. Dr. said it looked wierd to her and prescribed 10 days of 500 mg of Leviquin. Dr. told her to see an ENT 3 days later. ENT said it was not cancer, could see red bumps but not white spots and likely a common throat infection. He took a swab of her throat. I then went to get tested and came back positive for Gonorrhoeae, negative for Chlamydia. I was given a shot, 4 pills and then prescribed 10 days of Doxycycline. My symptoms cleared up the next day. I have been reading on your forum about resistance to fluoroquines (Leviquin). Does Leviquin still work for gonorrhoeae? We live in Florida. Could my wife get gonorrhoeae from vaginal sex 1 day after I had a risky encounter? Will swab of throat test positive for gonorrhoeae if she has been on Leviquin for 3 days?  Is Dr. checking for strep and would not test for gonorrhoeae since I didn't tell her? Do the improved symptoms mean she is cured? We have both been on antibiotics for 6 days now with no sex. Are we contagious? Should we be tested before resuming sex?  How long do we wait? Can I stop the Doxy because I didn't have Chlamydia?  Thanks, your forum is very educational.  

[Edward W Hook, MD]

Welcome to the Forum.  I will try to help.  Your story is a bit hard to follow but, as I understand it, you acquired gonorrhea of the penis from a sexual encounter outside of your marriage and were  treated with a shot, 4 pills and then 10 days of doxycycline.  In the interval between the encounter in which you caught gonorrhea and the time you were treated you had both vaginal and received oral sex form your wife.  She has been receiving treatment with levaquin but, to your knowledge, was not tested for gonorrhea (the routine throat culture would not detect gonorrhea) and does not know she was exposed.

If this summary is correct, I would be a bit concerned.  Gonorrhea of both the genital tract and the throat is typically asymptomatic in women so your wife could have been exposed.  Levaquin is effective for about 90% of gonorrhea infections but not all and, for that reason, is no longer recommended for gonorrhea.  My advice would be that, rather than take chances that she was cured by the levaquin, your wife needs to at least be tested for gonorrhea at both the throat and the cervix (genital tract) and treated for exposure, probably with the same medicines your received which, I suspect, were ceftriaxone (the shot) flagyl (the 4 pills) and doxycycline.

I hope this helps. EWH

[Edward W Hook, MD]

1.  Perhaps.  Levaquin is not particularly good for gonorrhea of the throat.  

2.  No, as I said, gonorrhea can be present in the throat without symptoms.

It sounds like you are trying to rationalize not telling your wife that she has been exposed to gonorrhea.  Do you really want to take the chance?  EWH

[ford12]

Two questions: 1) If my wife is amoung the 90% who do NOT have Leviquin resistant gonorrhoeae, is 10 days of Leviquin enough to cure it without a shot or other meds? 2) She was symptomatic with 2 red bumps with white centers but now they are gone, does this mean she is likely cured and does NOT have the drug resistant strain?