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Likelihood of having Pharyngeal Gonorrhea?

About a week ago, I performed unprotected oral sex on an 28 year old african american male who, when asked directly, adamantly asserted that he got tested quarterly, and at last test were completely std free.  I had already begun to come down with a cough, which I think may have been upper respiratory infection related, but I'm not sure.  The day after this incident, I began taking Claratin with pseudoephedrine for the cough and some sinus issues.

A couple days ago (4/5 days after exposure), returned to my job, which is in a very moldy/mildewy building.  I came down with a moderate sore throat, which has lingered for now a couple more days.  A friend, who is a doctor (I didn't tell the whole story) said it looked like I had pharyngitis, and thought, since I had the cough and was around the allergens, that it would likely clear sooner or later, dismissed strep, and didn't even think about gonorrhea.  I did not have swollen glands, but I did have whitish bumps on my tonsils, a bit of drainage from sinuses, and a sore throat.

My questions are:
1. Based on this, what is my likelihood of having Pharyngeal Gonorrhea? (or, "is the sore throat possibly Pharyngeal Gonorrhea?)  
2. Even if the person is showing no signs of infection, what is the rough rate of transmission from that activity assuming they were positive with either gonorrhea or chlamydia?
2. Will a Nucleic Acid Amplification Test pick up Pharyngeal Gonorrhea (and Chlamydia if I caught it too, a week ago)?  These are available at an easy-to-access STD testing place, and I'd rather go there than to a doctor and get the culture test done, but I'm unsure as to which is more accurate (specifically because I only would have gonorrhea in the throat, and while NAAT's seem well suited for genital infection, I can't tell how well they work for the throat)

Thanks!
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239123 tn?1267647614
MEDICAL PROFESSIONAL
Welcome to the forum.  I'm happy to help.  Bottom line:  It is exceedingly unlikely you have pharyngeal gonorrhea.

First, it is statistically unlikely your partner had urethral gonorrhea.  Not just because of his negative tests, but because urethral gonorrhea usually is not subtle -- asymptomatic infection is rare, and you probably would have seen pus dripping from his penis (in which case I doubt you would have performed oral sex on him!).  Second, although pharyngeal gonorrhea can cause sore throat, 95% of the time there are no symptoms.  To your specific questions:

1) For the reasons above, the chance you have pharyngeal gonorrhea is very low.

2) There are no data on transmission rate.  If your partner had urethral gonorrhea, maybe 50:50, but that's only a guess.

3) A NAAT on a throat swab would probably pick it up.  A urine or vaginal/cervical swab specimen cannot detect an infection of the throat.  Chlamydia isn't an issue; it almost never take hold in the throat.  CDC recommends against ever testing for pharyngeal chlamydia; it's that rare.

Since you're concerned, you could ask your doctor (or visit your local health department STD clinic) for a throat swab to test for gonorrhea, either by NAAT or by culture.  However, if I were in your situation, I wouldn't go to the trouble.

I hope this helps.  Let me know if there is anything in my reply you don't understand.

Regards--  HHH, MD
Helpful - 1
Avatar universal
Thanks for the response, that answers everything I needed to know!
Helpful - 0

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