Gonococcal pharyngitis.

The causative organism of gonorrhoea, Neisseria gonorrhoeae, has a special predilection for columnar epithelium. It is a delicate organism easily destroyed by heat, drying, mild antiseptics, and soap solutions. Transference of infection occurs when moist infective discharges come into contact with susceptible mucous membranes. Although the usual portal of entry of N. gonorrhoeae is the lower genito-urinary tract, the organism can enter at other sites, and infection may occur at any of the main orifices of the body. In males, infection of the rectum occurs in passive homosexuals. Nicol (1960) recorded 44 infections in the anal and four in both the anal and penile sites in 135 cases of gonorrhoea among homosexuals. Scott and Stone (1966) found rectal gonorrhoea in 36 of 82 male passive homosexual contacts of patients suffering from gonorrhoea. Infection of the mouth and pharynx by the gonococcus appears to be very infrequent according to reports in the literature. Gonococcal stomatitis is a rare condition. Frazer and Menton (1931), in reporting such a case, stated that only about forty cases had been recorded previously, and only two cases have been reported since (Copping, 1954; Schmidt, Hj0rting-Hansen, and Philipsen, 1961). In neither of these cases, however, was there complete proof that N. gonorrhoeae was the causative organism. Diefenbach (1953) described a case of gonococcal parotitis in a male homosexual who had performed fellatio. The first case of gonococcal pharyngitis was reported by Fiumara, Wise, and Many (1967). The pharynx was diffusely dark red and oedematous. A smear from the throat showed Gram-negative intracellular diplococci, confirmed by culture on Thayer Martin V.C.N. medium and sugar fermentation tests as N. gonorrhoeae. Eight of the patient's nine contacts were seen. Two of them had pharyngitis. Throat smears from both showed Gram-negative intra-cellular diplococci and throat cultures on Thayer Martin V.C.N. medium grew oxidase positive colonies, but there was no growth on sugars.