Oropharyngeal gonorrhea during pregnancy

The frequency of oropharyngeal infections with Neisseria gonorrhoeae in pregnant women was studied in two prenatal clinics in Bandkok, Thailand. A third group of women visiting a dental clinic on a routine basis was included for comparison purposes. Group I, from an American dependent clinic, had an oropharyngeal infection rate of 15% while only 0.7% had cervical infections. None had infections in more than one site. In Group III, from a Thai clinic, no patients had oropharyngeal infections while 11.9% had infections from either the cervix or rectum or both. One and eight-tenths percent of the patients attending the dental clinic had oropharyngeal infections. Oropharyngeal gonorrhea was found in a prenatal population of American military dependents at a high rate. We propose that all women visiting a prenatal clinic routinely have their oropharynx cultured for N gonorrhoeae.

Pharyngeal gonorrhoea in homosexuals

In a prospective survey of 106 male homosexuals, investigations included smears and cultures of material taken from the tonsillar areas. A diagnosis of gonococcal pharyngitis was made in six cases. This is the largest series so far reported from England. The prevalence of gonorrhoea nd less conventional sexual practices must prompt us to investigate gonococcal infection in sites remote from the ano-genital region.

Gonorrhoea of the throat at a venereological clinic. Incidence and Results of Treatment

Among 3,271 consecutive cases of gonorrhoea seen during the years 1971 to 1974, the incidence of tonsillar gonorrhoea was 3-6% in men and 5-8% in women. Oro-genital intercourse was admitted by 34% of men and 33% of women. Among these patients the incidence of tonsillar gonorrhoea was 7% in men and 16% in women. Only two cases of gonococcal septicaemia were seen, and there were no other complications. Few patients experienced symptoms from the throat. Tonsillar cultures was positive on the first examination in only 74%, it was negative until after single-dose treatment had been given in 18%.

Incidence, predisposing factors and outcome of pharyngocutaneous fistulas complicating head and neck cancer surgery

A major complication of head and neck cancer surgery following radiation and extensive resection is pharyngocutaneous fistula. A retrospective analysis of 36 fistula patients out of 376 major head and neck procedures between January 1971 and July 1973 revealed certain guidelines for improved clinical management. Since a large discrepancy existed in the incidence of fistulas between the different surgical procedures, each operative group was examined separately. The incidence, predisposing factors, and methods of treatment for this complication following composite jaw-neck resections and various laryngeal procedures are analyzed and discussed.

Faucial bonorrhoea

Nine hundred patients (250 females and 650 males) attending the Clinic for the Treatment of Venereal Diseases had throat swabs taken as a routine; 1-1% (1-6% of females and 0-92% of males) were found to have faucial gonorrhoea. This figure appears to be similar to that found by Odegaard and Gunderson (1973) in Norway. The treatment regime used in the clinic in Perth appeared to be satisfactory, as there were no failures. It is stressed that all patients suspected of suffering from venereal disease should have their throats swabbed as a routine. Information as to whether or not oral sex is practised should be obtained.

Asymptomatic epidemic acquisition of group A Streptococcus: antibody response to extracellular and type-specific antigens

The antibody response of 40 institutionalized children involved in an epidemic associated with asymptomatic pharyngeal acquisition of a group A, M-11, T-11 typeable Streptococcus was studied. Titers of antibody to streptolysin O and to deoxyribonuclease B determined in sera collected from patients within two weeks of positive throat cultures were significantly higher than those in sera of controls (P smaller than 0.001). However, there was no rise in antibody titers in sera obtained from these patients after an interval of three weeks. Type-specific antibody to the group A Streptococcus (type M-11) was assayed in the sera of 24 patients. No detectable antibody activity was found either in the initial sera or in sera collected eight months after the epidemic. Thus, the asymptomatic nature of this epidemic could not be attributed to the presence of detectable type-specific antibody in this population at the time of the epidemic. These observations suggest that asymptomatic pharyngeal acquisition of group A Streptococcus may occur in epidemic fashion in certain populations and may not be associated with evidence of an antibody response to the streptococcal organism.

Gonorrhoea in 1972. A 1-year study of patients attending the VD Unit in Uppsala

During 1972 a total of 2,090 men and 1,489 women were seen in the VD clinic in Uppsala, Sweden. The most frequent diagnosis among the men was non-gonococcal urethritis (38 per cent.) and among the women non-gonococcal vaginitis (34 per cent.), N. gonorrhoeae was found in 22 per cent. of the men and in 33 per cent. of the women, 68 per cent. of the men with gonorrhoea attended because of symptoms, but 67 per cent. of the men without gonococcal infections came for the same reason. 39 per cent. of the women with gonorrhoea attended after being told by their sexual partner; it was found that women coming because of symptoms were most likely to have non-gonococcal infection. Gonorrhoea without subjective symptoms was found in 23 per cent. of the men and 50 per cent. of the women. Gonorrhoea was found in association with scabies in 9 out of 18 men and in 3 out of 5 women. A rising incidence of pharyngeal gonococcal infections has been noticed at the clinic and the figures for 1972 were 6 per cent. of the men and 9 per cnet. of the women with gonorrhoea. The route of infection was usually oro-genital contact, but in some cases other routes had to be considered. It was not possible to define a promiscuous group of patients suitable for a planned study of prophylactic treatment, as only 2 per cent. of the men and 1 per cent. of the women had had nore than one gonococcal infection during the preceding year. The standard treatment for genital gonorrhoea (ampicillin 2 times 1 g. orally with a 5-hour interval) was very satisfactory and gave a 98 per cent. cure rate. This was possible because there were few gonococcal strains with decreased panicillin sensitivity. There were considerable problems in treating the pharyngeal infections, the standard treatment failing in 61 per cent.