Sexually transmitted infections of the oral cavity

Various sexual practices like fellatio, cunnilingus, or anilingus (rimming) can cause both symptomatic and asymptomatic oral infections in both sexes. Clinically apparent lesions are found in primary, secondary, and tertiary syphilis, in acute HIV infection and the subsequent stage of immunodeficiency (opportunistic infections), as well as in herpes and human papilloma virus infections. Genital candidiasis also can be transmitted to the oral cavity. Depending on the infective agent transmitted, ulcerative, inflammatory or papillomatous lesions of the lips, tongue, mucous membranes and pharynx occur. Oropharyngeal infections with Neisseria gonorrhoeae or Chlamydia trachomatis (Serovar D-K) can cause pharyngitis and tonsillitis with sore throat, but are completely asymptomatic in most cases. Asymptomatic infections are an important, but frequently overlooked reservoir for new infections. Systemic treatment of oral STI's usually is the same as that for anogenital infections. It can be accompanied by symptomatic topical therapy. When the tonsils and other difficult to reach tissues are infected, higher doses and an antibiotic with good tissue penetration are recommended.