Gonorrhea in the Throat and Eye

Gonorrhea is best known as a genital infection, but the bacteria can also live in the throat and the eyes. Both are worth knowing about, and one of them is an emergency.

Can you get gonorrhea in your throat?

Yes. The CDC says gonorrhea can cause infection in the genitals, rectum and throat. You can get it through oral sex without a condom with someone who has the infection. MedlinePlus says the bacteria can infect the genital tract, mouth or anus.

Throat infections matter for two reasons. They are easy to miss, and they are harder to clear. The CDC says the majority of gonococcal infections of the throat are asymptomatic, and can be relatively common among certain groups. It also notes that throat infections have been reported to be a major source of community spread.

What are the symptoms of throat gonorrhea?

Often there are none. When there are symptoms, the NHS and MedlinePlus both list a sore throat. A sore throat is far more often a cold or a virus, so it does not mean you have gonorrhea. It is, however, a reason to choose a test that includes a throat swab if you have had oral sex.

How is throat gonorrhea tested?

A swab is taken from the throat. The CDC says swabs are used when you have had oral sex, and that throat testing should be done for people with genital or rectal gonorrhea who report oral sex. A urine sample alone may not pick up a throat infection. The NHS says STIs can take up to 7 weeks to show on a test, so timing matters. See our window periods guide.

You can usually collect some swabs yourself, since the CDC says patient-collected swabs are a reasonable alternative.

How is throat gonorrhea treated?

With an antibiotic injection from a clinician. The CDC recommended treatment is the same injected antibiotic used at other sites, and it notes that no reliable alternative treatments are available for throat gonorrhea. If you have a severe allergy to this antibiotic, a specialist will advise.

Because the throat is harder to clear, the CDC asks everyone treated for it to come back 7 to 14 days later for a test of cure. If the repeat test is positive, the CDC advises trying to confirm it with a culture before treating again. Do not have sex until seven days after treatment and until your partners have been treated.

Can gonorrhea infect the eye?

Yes. The NHS lists eye redness, pain and discharge among the signs of gonorrhea outside the genitals, and says the eye can become infected if you touch your eyes after touching infected fluid from the penis or vagina. MedlinePlus notes the bacteria can grow in the eyes too.

This is not a wait-and-see problem. The NHS lists red, itchy or painful eyes, or pus that sticks to your eyelashes, as signs of a more serious gonorrhea infection that needs to be treated quickly. In the US, go to urgent care or an emergency department the same day.

How is gonorrhea in the eye treated?

The CDC recommends an antibiotic injection, and says one-time rinsing of the infected eye with saline can be considered. Because eye infections are uncommon in adults and treatment data are limited, an infectious disease specialist may be consulted. Eye treatment should be directed by a clinician.

Partners need to be tested and treated too.

What about babies?

Gonorrhea can pass to a baby’s eyes during birth. The NHS says this can cause blindness if it is not treated with antibiotics. This is one reason why testing and treatment in pregnancy matter. The CDC says to talk to your provider about examination, testing and treatment if you are pregnant, since treating gonorrhea as soon as possible makes problems for the baby less likely.

How can I lower my risk?

• Use a condom over the penis, or a latex or plastic square (dental dam) over the vulva, for oral sex (NHS).
• Test regularly if you have new or multiple partners. You can order a test online.
• Avoid touching your eyes after contact with genital fluid.
• Finish treatment, and wait until partners are treated before having sex again.