Localization of gonococci in the anterior oral cavity--a possible reservoir of the gonococcal infection?

In a 6 months period pharyngeal gonococci were detected by routine cultures in 74 (8%) of 951 patients with gonorrhoea. In approximately one third of the 74 patients, a positive culture from the pharynx was the only sign of a gonococcal infection. Fourteen (19%) of the 74 patients with pharyngeal gonorrhoea also had positive cultures of Neisseria gonorrhoea from vestibulum oris. In spite of thorough contact tracing and interview concerning sexual practices in all these patients and when possible their sexual partners, we were not able to show directly that gonococci located in the oral cavity and especially in its anterior part also served as a reservoir of infection. However, three patients with exclusively pharyngeal gonorrhoea denied genito-oral sexual intercourse and could probably have been infected by strictly oro-oral contact. It is concluded that the existence of pathogenic bacteria in the anterior oral cavity in a large proportion of patients with pharyngeal gonococcal infection strengthen the possibility of this localization as a source of the infection.