FELLATIO AND CHLAMYDIA TRACHOMATIS PHARYNGITIS

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What is the real risk of Chlamydia transmission through genital/oral contact? Since there is no treatment, is oral infection with Chlamydia an incidental finding, or is it something of concern? How long can the organisms survive in the throat?
—Mimi Tannen, NP, Poughkeepsie, N.Y.

Chlamydia trachomatis has been cultured not only from the pharynges of asymptomatic people who have engaged in orogenital sex, but also from patients with symptomatic pharyngitis after fellatio. However, the risk of C. trachomatis transmission through orogenital contact is difficult to assess since many women are asymptomatic and do not seek treatment (Sex Transm Infect. 1998;74:95-100 and J Clin Microbiol. 1984;20:993-994).

Although some investigators have proposed that detection of C. trachomatis in the pharynx after orogenital contact may be a result of colonization rather than infection, others speculate that the presence of organisms at this site may be important in the transmission or persistence of C. trachomatis infections (Laryngorhinootologie. 1989;68:157-159 and Ann Intern Med. 1985;102:757-762). Various oral antibiotics can be used to treat chlamydia; some of these include doxycycline (100 mg twice daily for seven days), azithromycin (Zithromax) (1 g for one dose), fluoroquinolones, and erythromycin.
—Philip R. Cohen, MD (106-16)

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