Screening for pharyngeal gonorrhea in the urban teenager

A retrospective chart review assessed the occurrence of pharyngeal gonorrhea among 546 teenagers who attended a general adolescent clinic and were cultured for gonorrhea; they had been routinely cultured at three sites (cervix/urethra, rectum, and pharynx) regardless of their history of sexual practice. No record of specific sexual practice was available. This population was predominantly urban, black, and female; the age range was 11 to 22 years (mean = 16.5). The overall occurrence of gonorrhea was 14.7% (80/546). Pharyngeal gonorrhea was detected in 2.7% of the study population, representing 12 females and three males. Of the 80 patients with gonorrhea, 15% had only pharyngeal gonorrhea. History was available for 13/15 patients none had pharyngeal symptoms. Approximately half were detected by routine screening at a family planning visit; the remainder had complaints related to sexually transmitted disease. The occurrence of pharyngeal gonorrhea is sufficiently high to merit study of the indications for pharyngeal culture of teenaged patients. Given the potential for disseminated infection and absence of information regarding the reliability of self-report, it currently appears appropriate to culture adolescents routinely for pharyngeal gonorrhea, regardless of stated sexual practice, whenever genital cultures are collected.