Oral (pharyngeal or oropharyngeal) gonorrhea and strep throat are two different health conditions that may cause you to get a sore throat.
So how can you tell the difference?
Read on to find out how to distinguish strep throat from oral gonorrhea.
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Strep throat and oral gonorrhea differ in many ways, despite both potentially causing a sore throat.
Strep throat and oral gonorrhea cause largely different symptoms, so you may be able to tell which condition you have based on how you’re feeling. However, remember that both conditions can cause a sore throat, swollen lymph nodes in the neck, and fever.
Other symptoms of strep throat include:
Pain when swallowing
Swollen, red tonsils (you might see white patches or pus)
Small red spots on the roof of your mouth
If you get a cough, runny nose, conjunctivitis, or a hoarse, raspy voice, you may have viral tonsillitis, not strep throat.
On the other hand, oral gonorrhea may not cause any symptoms at all. This is why regular testing is important if you are sexually active.
In addition to a sore throat, swollen lymph nodes in the neck, and fever, oral gonorrhea may also cause trouble swallowing.
It’s important to be aware of genital gonorrhea symptoms, too, as you risk spreading the bacteria to your throat if you or a sexual partner have it. Gonorrhea symptoms may include:
Bleeding between periods
Abnormal vaginal discharge (it may be bloody or yellow)
Abnormal discharge from the penis (it may be white, yellow, or green)
Itching around the anus
A burning sensation or pain when you urinate
Pain when you pass a stool
Painful or swollen testicles
Strep throat and oral gonorrhea are caused by different things.
Strep throat is caused by streptococcus bacteria.
You can contract strep throat by inhaling respiratory droplets containing bacteria or touching them and transferring the bacteria to your nose or mouth. Someone with the infection can spread the bacteria by talking, sneezing, or coughing.
Streptococcus bacteria can also cause impetigo, a skin infection that causes sores. You can contract strep throat by touching a sore or coming into contact with fluid from them.
You may develop strep throat two to five days after exposure to the bacteria. People infected with streptococcus bacteria don’t necessarily show symptoms, but anyone can spread it. People with symptoms are more contagious than those who don’t.
Oral gonorrhea is contracted differently. It is caused by Neisseria gonorrhea bacteria (also called gonococcus), which is mainly found in vaginal fluid and discharge from the penis.
You can contract oral gonorrhea if you have unprotected oral sex. It is less common than genital gonorrhea.
The two conditions carry different health risks and the possibility of complications. With either condition, risks arise from bacteria spreading to other parts of the body.
Strep throat can be treated with antibiotics, but in rare cases, it can lead to complications. These include:
Sinus infection — symptoms include a blocked nose and green or yellow nasal mucus
Middle ear infection — symptoms include ear ache
Peritonsillar abscess — symptoms include pain in the throat that gets progressively worse, difficulty opening your mouth, muffled speech, high temperature, body aches, nausea, and constipation
Poststreptococcal reactive arthritis (PSRA) — symptoms include joint swelling and pain
Scarlet fever — symptoms include high temperature, a red, patchy rash, a swollen tongue which may be white or red and bumpy, and swollen glands in your neck
Rheumatic fever — symptoms include fatigue, swollen, painful joints, chest pain, breathlessness, rapid heart rate, small bumps under your skin, and jerky movements in your face, feet, or hands
Post-streptococcal glomerulonephritis (a kidney infection) — symptoms include rust-colored urine, blood in the urine, or difficulty urinating
Seek medical advice if you develop any of the symptoms listed above.
Oral gonorrhea may spread if you do not get tested and leave the condition untreated. The bacteria can remain for three to four months, and you will be at risk of spreading the bacteria to sexual partners during this time.
In rare cases, Neisseria gonorrhea (the bacteria responsible for oral gonorrhea) can enter the bloodstream and cause disseminated gonococcal infection (DGI). DGI can cause serious complications, including septic arthritis, tenosynovitis, polyarthralgia, meningitis, or endocarditis.
Seek medical advice if you develop any of the following symptoms of DGI:
Rash (red or pink spots that may be filled with clear fluid or pus)
Swelling around the joint
Redness around the joint
Pelvic inflammatory disease (PID) may occur if gonorrhea spreads to the reproductive organs. This can cause infertility, ectopic pregnancy, or long-term pelvic pain.
Gonorrhea can also cause problems in pregnant women. It may cause miscarriage, premature labor and birth, conjunctivitis in the baby, and permanent blindness.
The infection can cause fertility problems in men, as well as pain in the prostate gland and testicles.
Antibiotics are the primary treatment for both strep throat and oral gonorrhea. However, each condition is treated with different antibiotics.
Penicillin or amoxicillin are prescribed to treat strep throat. If you are allergic to penicillin, your doctor may prescribe a different antibiotic.
Doctors typically prescribe cephalosporins, a type of antibiotic, to treat oral gonorrhea, but antibiotic resistance is worsening. Cephalosporins are currently the last available treatment for the condition. An antibiotic called ciprofloxacin used to be prescribed, but this is now largely ineffective.
These antibiotics come in different forms, including liquid, capsules, and tablets. Many antibiotics can cause side effects such as diarrhea, nausea, vomiting, stomach cramps, and headache. Only take antibiotics under medical supervision.
If you continue to experience symptoms after taking antibiotics for either strep throat or oral gonorrhea, see your doctor.
Strep throat and oral gonorrhea are caused by different bacteria. You contract each infection differently. They also present different symptoms, cause complications, and are treated differently. You may be able to tell which infection you have from the information above, but your doctor can also carry out tests to identify the infection.
Once you notice symptoms like fever, sore throat, swollen glands under your jawbone, and tenderness around your ears, neck, or chest, it’s time to visit a doctor.
Your doctor will take a swab sample from your throat if they suspect you have strep throat or oral gonorrhea.
Testing for strep throat involves a rapid strep test. Your doctor may also take a throat culture swab if your rapid strep test is negative, but they still suspect you have a streptococcus infection. This may identify another condition caused by the bacteria.
Testing for oral gonorrhea also involves a throat swab and culture. You can ask for a throat swab during regular gonorrhea testing if you have been having oral sex. You should also get tested for a genital gonorrhea infection, which may involve a urine sample and swab from the end of the penis for men or a swab from the cervix, vagina, or urethra for women.
You can catch strep throat from other people carrying the bacteria. Remember, they may not have symptoms. Try to wash your hands as much as possible and avoid sharing glasses, mugs, or cutlery with other people to avoid contracting the infection.
You can take steps to prevent oral and other gonorrhea infections by practicing safe sex. Avoiding unprotected sex is key.
Ensure you use condoms consistently and correctly during sexual activity. Prevention involves avoiding unprotected sexual contact and using condoms correctly. During oral sex, use a condom to cover the penis or a plastic or latex square (a dam) to cover the vagina.
Strep throat and oral gonorrhea share some symptoms: a red or sore throat, fever, or swollen lymph nodes in the neck. However, oral gonorrhea often causes no symptoms at all.
The two conditions are caused by different bacteria and manifest in different ways. They are also caused by different things, so you wouldn’t contract strep throat like oral gonorrhea. Furthermore, both conditions are treated with different antibiotics.
You may be able to work out whether your symptoms are caused by strep throat or oral gonorrhea based on the information above. But it’s a good idea to see a doctor and have a throat swab taken to make sure.
Both conditions can cause serious complications, so your doctor will prescribe medication for you.
Strep throat: All you need to know | Centers for Disease Control and Prevention
What are the symptoms of gonorrhea? | Planned Parenthood
Gonorrhea | Planned Parenthood
Oral (oropharyngeal) gonorrhea: what it is and how it’s treated | Ro Health Guide
Disseminated gonococcal infection (DGI) patient education flyer | California Department of Public Health
Scarlet fever: All you need to know | Centers for Disease Control and Prevention
Rheumatic fever: All you need to know | Centers for Disease Control and Prevention
Antimicrobial-resistant gonorrhea basic information | Centers for Disease Control and Prevention
Gonorrhoea | NHS
Disseminated gonococcal infection (DGI) | California Department of Public Health2600