Repeated infection from Oral Sex

[chman]

A couple of months ago I developed urethritis after receiving oral sex from my girlfriend. We subsequently had vaginal intercourse but only after I had put on a condom. The following day I noticed a small amount of a cloudy yellow discharge. Though I had engaged in sexual activity with another woman some days before it had been very brief and with protection the entire time, so I am pretty sure the symptoms were from the contact with my girlfriend. Also, my girlfriend had complained that evening before we had sex that she thought she was developing a sore throat. I decided to self-treat with a course of doxy-cycline and the symptoms went away within a few days though I completed the entire 10 day course of antibiotics.  No symptoms after that.

We were apart for a couple of months, and I didn't mention it to her. For some reason I assume it would simply resolve itself in her case. After all, her sore throat did go away.
A few nights ago, we had sex for the first time since, and  I have had no other sexual contact with other women. Again, exactly the same thing happened - the next day a small amount of a cloudy yellow discharge.

Questions:
1) I don't believe she is sexually active outside of our relationship (though anything is possible I suppose). Are there bacteria that can infect a persons mouth or throat that can cause symptoms of urethritis outside of the usual ones like chlamydia/gonnorhea?

2) Can such an organism survive in the mouth/throat for over two months with no symptoms?

3) What is going on and why do the symptoms seem to develop so quickly  (overnight, no more that 12 hours later).

[Edward W Hook, MD]

Welcome to the Forum. Urethritis following receipt of oral sex can arise in two ways - either by transmission of a known STD pathogen such as gonorrhea during contact or through introduction of bacteria from the throat of the person performing oral sex into the urethra of the recipient.  When gonorrhea or other pathogens are involved it is the nature of the bacteria that leads to infection.  On the other hand when it is mouth organisms from the active partner, it is likely that there are issues related to technique that lead to introduction of normal throat bacteria into the urethra which then go on to cause irritation.  When this sort of NGU caused by non-traditional pathogens occurs it is thought (as you might imagine, this would be very difficult to study) that there is less risk for transmission to others and probably for complications.  

Assuming that your statement that neither you nor your partner has had other recent partners, is that your urethritis has resulted from introduction of the sorts of mouth bacteria that everyone caries, and not classical STD pathogens into your urethra.  I would simply treat you for NGU using either doxycycline or perhaps azithromycin.  It is not clear that your partner needs treatment in this situation but many would choose to err on the side of caution and treat her as well.  

Hope these comments are helpful.  Take care.  EWH

[Edward W Hook, MD]

Yes, it is rather unusual, typically STD symptoms take 2 or more days to develop.  As you already know your situation is a bit unusual.  In working to sort this out, I might suggest that you and your partner consider using condoms for oral sex for a while to see if it prevents your symptoms from recurring.  If it does, then you try again without condoms and get recurrent symptoms it would provide you with an understanding of what is going on.  EWH

[chman]

Thanks. The comments were very helpful.
Is it unusual that the symptoms developed so quickly after contact in both cases (within 12 hours)? I thought that it normally takes at least a couple of days for symptoms like mine to appear.