Gonococcal tonsillitis

oralmedicine Editor:

JAMESW.LITTLE,D.M.D.,M.S.D. Chairman and Professor Department of Oral Diagnosis and Oral Medicine University of Kentucky Lexington, Kentucky 40506

Gonococcal tonsillitis Report

Robert RAF

of a case

J. Jam&y,

CHICKSANDS,

Major,

UXAP

APO NEW

YORK,

(DC) N. Y.

Oral gonorrhea tonsillitis findings, reviewed.

is not a commonly reported entity. One case of primary gonoeoccal in a 20.year-old Caucasian man is reported. The clinical and laboratory differential diagnosis, and treatment of gonococcal infections are bricflq-

G

onorrhea, though considered primarily a disease of the genitourinary tract, can cause severe systemic infection. Gonococcal meningitis, pericarditis, myocarclitis, dermatitis, arthritis, and perihepatitis have been frequently reported in the medical literature.“, I4 Gonorrhea1 tonsillitis,1 pharyngitis,3 stomatitis,‘, 4, ’ and parotitis” have been reported in the literature. It is the purpose of this article to report a case of primary gonococcal tonsillitis. The natural history, laboratory findings, diagnosis, differential diagnosis, and treatment will be briefly rcviewd. Since early recognition and treatment of this clistlase can prevent serious sequelae and since it ran be present in the oral and perioral structures, it is imperative that the dental practitioner becomes aware of its existence and takes appropriate measures. CASE

REPORT

In >‘ehruary, 1974, a 20-year-old Caucasian man presenkd Air E’owo Base in Thailand, complaining of “sore throat.” tonsillitis was made by a medical officer, and the patient

This Garmisch,

paper was presented Germany Oct. 8-10,

before 1975.

the

USAFE

Annual

to the medical clinic of U-Tapao A tentative diagnosis of acute was hospitalized. Initial physical

Medical-Dental

Conference,

AFXC

197

\.i::ii.i.

: “, i,r::

Pathogenesis

Laboratory

findings

Differential

diagnosis

,\c!nte tonsillitis, pharyngcal dipht,hcria, alid pharyngyal strcptococcat infections Illi>!- have a superficial appwranw similar to gonwoccal infections. Also, scij t*l(lt fcx-cr ant1 infectious nlononu~leosis must be ruletl out.’ These conditions ;tr(x atl iclwltifiablc by their approIiri;ttc clinical signs ant1 laborator?_ stu&x7 Treatment

‘I%~ treatment of choiw is aqueous procaine pcnivitlili iI1 a dose of 4.8 million units intramuswlarl>-, precetlcd by oral administration of 1 (:m. of probcnccitl AItcmateIp, tetracycline is a good chOice.‘~ !’ one half-hour prior to injection.2 I~‘ollow-up is atldsablc to cnsurv rcsoll~tion and oliminatc the carrier state.

Oral

.\ugust.

slug.

19ii

Prognosis

SUMMARY

Oral gonococcal infections are ~)rol)ably more common than suspected. Transmission to a dentist or other l)atient can occur through infected instruments or. possibly, direct finger wntact. Dental manipulation of an infected area may cause ll~~lll~ltO~~~ll~~US SplY’iltl 01’ ii gOllOCO~~~l1 osteitis. ‘I’hca dental l~rac~tiiioilc~r \voultl Iw wsll advised ilgainsl performing all t%Y’pt the most urgent clcvital trwtmcnt 011 it patirnt suspc~4cd of having sU(‘h RI1 infection. If a patient has a suspwtcd go~iococcus infcvtion and clcntal treatment must hc pcrformctl. rablwr gloves, a l’aw mask, and c,llcmotherapeutic prophyla&c measures well iltl\-iWt1. ~1190, the patient sh0uId hC tacdtfLLll>Wf(?ITPd For mctlical cart. ilr('

REFERENCES 1. 2. 3. 4. 3. 6. T. 8. 9. 10.

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