Gonococcal oro- and nasopharyngeal infection.

Although known to occur in the past, it is only in recent years that the incidence and importance of oral infection by the gonococcus has come to be assessed. The first case of gonococcal pharyngitis was described by Fiumara, Wise, and Many (1967). Thatcher, McCraney, Kellogg, and Whaley (1969) found no gonococci in the urethra and rectum in a routine screening by culture of 505 military subjects; in one case, they obtained a positive culture from the pharynx. Gonococcal ulceration of the tongue was described by Cowan (1969) in a female patient with gonococcal cervicitis and urethritis. Metzger (1970) described one patient with gonococcal pharyngitis, septicaemia, and polyarthritis. A possible case of gonococcal tonsillitis was described by Iqbal (1971). In a series of fifty patients with gonorrhoea who admitted recent orogenital contact, Heligren (1971) isolated gonococci from the tonsils in one out of twenty women and one out of thirty men. BroJ0rgensen and Jensen (1971), investigating unselected Danish patients with gonorrhoea, found gonococci in the tonsils in six (6 per cent.) of 95 Danish men and in six (9 per cent.) of 66 women. Among 49 foreign men with gonorrhoea, the incidence was 2 per cent. Of 71 Danish men 57 (80 per cent.), and of 62 Danish women 38 (61 per cent.), stated that they had had orogenital contact during their last sexual experience; it was much more commonly practised with regular partners than with casual contacts. Owen and Hill (1972) reported eleven positive cultures from the pharynx in an investigation of 79 homosexual men in the U.S.A. Rodin, Monteiro, and Scrimgeour (1972), in London, found only one positive culture in 73 throat swabs from 65 male homosexuals, 33 of whom had urethral or rectal gonorrhoea; half of these 65 patients admitted recent orogenital contact. Ratnatunga (1972) described three gonococcal infections of the pharynx in male homosexuals. These three cases were diagnosed in a V.D. clinic where 113 men with gonorrhoea (including 23 homosexuals) were diagnosed in the same year.