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12.6 Oropharyngeal STIs

Table of Contents

  • Oral sex can lead to oropharyngeal STIs (infections of mouth and throat), including human papillomavirus, herpes, gonorrhea, among others. Clinically, it is difficult to diagnose gonococcal or chlamydial pharyngitis reliably.
  • Additionally, service providers should be aware that pharyngeal gonorrhea can be more difficult to clear than urethral infections.
  • Other oro-pharyngeal STIs (such as herpes and warts) can often be detected by physical examination and can be managed according to the treatment guidelines. It is recommended that whenever a patient is suffering from significant pharyngitis, and a history of unprotected oral sex makes pharyngeal gonococcal or chlamydial infection a likely risk, the patient should be treated syndromically.

Treatment for sexually-transmitted Pharyngitis

D: Cefixime, 400 mg PO stat (to treat gonococcal infection)

AND

A: Azithromycin, 1 g PO stat (to treat chlamydial infection)

Management and Treatment of Oropharyngeal STIs (see flow chart 12.6)