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June 5, 1972

Rectal and Pharyngeal Gonorrhea in Homosexual Men

JAMA. 1972;220(10):1315-1318. doi:10.1001/jama.1972.03200100031006

To identify and treat rectal gonorrhea in male homosexuals, a physician took rectal, pharyngeal, and urethral specimens from all of his known homosexual patients. Of 26 patients with general medical complaints five had rectal gonorrhea, as did 19 of the 46 patients suspected of having this infection and two of seven with urethritis. Similar rectal symptoms occurred in those with and those without rectal gonorrhea, suggesting that symptoms are not directly related to gonorrheal infection. Pharyngeal cultures from 11 patients were positive for gonorrhea, but only three patients were symptomatic. Neither of two common regimens used for treatment in one visit (4,800,000 units of penicillin G procaine administered intramuscularly or 3 gm of tetracycline hydrochloride taken orally) was effective enough to use without follow-up cultures. Homosexuals are important carriers of gonorrhea; rectal and pharyngeal cultures are essential for diagnosis and treatment of these patients.