• Emily Popler
  • Judson J. Miller


Pharyngitis is defined as an inflammation of the pharynx and mucous membranes. The differential diagnosis for an adolescent presenting with the complaint of “sore throat” is broad and includes infectious causes, allergic causes, irritants, and trauma. In sexually active adolescents, it is also important to consider viral and bacterial sexually transmitted infections (STIs) as a possible cause of oropharyngeal symptoms. At the same time, it is important to note oropharyngeal STIs are frequently asymptomatic. Thus, this chapter will also include a discussion of the major sexually transmitted pathogens that may be present in the oropharyngeal space even when patients have no complaint of “sore throat.”


  1. 1.
    Stedman TL. Stedman’s medical dictionary. 28th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. Pharyngitis.Google Scholar
  2. 2.
    Nicoteri JAL. Adolescent pharyngitis: a common complaint with potentially lethal complications. J Nurse Pract. 2013;9:295–300.CrossRefGoogle Scholar
  3. 3.
    CDC. National ambulatory medical care survey factsheet pediatrics. 2010. NAMCS(FS)-Pediatrics 12 (2–13). Available at: Accessed 7 Nov 2016.
  4. 4.
    Ballini A, Cantore S, Fatone L, Montenegro V, De Vito D, Pettini F, Crincoli V, Antelmi A, Romita P, Rapone B, Miniello G, Perillo L, Grassi FR, Foti C. Transmission of nonviral sexually transmitted infections and oral sex. J Sex Med. 2012;9:372–84.CrossRefGoogle Scholar
  5. 5.
    American College of Obstetricians and Gynecologists. Committee Opinion No. 582: addressing the health risks of noncoital sexual activity. Obstet Gynecol. 2013;122:1378–82.CrossRefGoogle Scholar
  6. 6.
    Sutter Health Palo Alto Medical Foundation. Safer oral sex practices [Internet]. 2013. Available at: Accessed 7 Nov 2016.
  7. 7.
    Kann L, McManus T, Harris WA, Shanklin SL, Flint KH, Hawkins J, Queen B, Lowry R, O’Malley Olsen E, Chyen D, Whittle L, Thornton J, Lim C, Yamakawa Y, Brener N, Zaza S. US Department of Health and Human Services/Center for Disease Control and Prevention. Youth risk behavior surveillance – United States, 2015. MMWR. 2016;65:1–174.CrossRefGoogle Scholar
  8. 8.
    Center for Disease Control and Prevention. Youth risk behavior surveillance system (YRBSS) overview [Internet] 2016. Available at: Accessed 9 Oct 2016.
  9. 9.
    Copen CE, Chandra A, Martinez G. Prevalence and timing of oral sex with opposite-sex partners among females and males aged 15–24 years: United States, 2007-2010. Hyattsville: National Center for Health Statistics; 2012. 14 p. Report No.: 56Google Scholar
  10. 10.
    CDC/National Center for Health Statistics. Key statistics from the National Survey of Family Growth – S Listing [Internet]. 2015. Available at: Accessed 25.
  11. 11.
    Kaiser Family Foundation. National survey of adolescents and young adults: sexual health knowledge, attitudes and experiences. Menlo Park. 2003. Accessed 25 Aug 2016.
  12. 12.
    Haydon AA, Herring AH, Prinstein MJ, Halpern CT. Beyond age at first sex: patterns of emerging sexual behavior in adolescence and young adulthood. J Adolesc Health. 2012;50:456–63.CrossRefGoogle Scholar
  13. 13.
    Vasilenko SA, Kugler KC, Butera NM, Lanza ST. Patterns of adolescent sexual behavior predicting young adult sexually transmitted infections: a latent class analysis approach. Arch Sex Behav. 2015;44:705–15.CrossRefGoogle Scholar
  14. 14.
    Halpern-Felsher BL, Cornell JL, Kropp RY, Tschann JM. Oral versus vaginal sex among adolescents: perceptions, attitudes, and behavior. Pediatrics. 2005;115:845–51.CrossRefGoogle Scholar
  15. 15.
    Bersamin MM, Fisher DA, Walker S, Hill DL, Grube JW. Defining virginity and abstinence: adolescent’s interpretations of sexual behaviors. J Adolesc Health. 2006;41:182–8.CrossRefGoogle Scholar
  16. 16.
    Jenkins WD, LeVault KR. Sexual history taking in the emergency department – more specificity required. J Emerg Med. 2015;48:143–51.CrossRefGoogle Scholar
  17. 17.
    US Department of Health and Human Services Center for Disease Control and Prevention. A guide to taking a sexual history. CDC Publication: 99–8445. Accessed 1 Dec 2016.
  18. 18.
    Bickley LS. Bates’ guide to physical Examination and history taking. 10th ed: Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2009.Google Scholar
  19. 19.
    Holway GV, Hernandez SM. Oral sex and condom use in a US sample of adolescents and young adults. J Adolesc Health. 2018;62(4):363–4.CrossRefGoogle Scholar
  20. 20.
    Beharry MS, Shafii Tm Burstein GR. Diagnosis and treatment of chlamydia, gonorrhea, and trichomonas in adolescents. Pediatr Ann. 2013;42:26–33.CrossRefGoogle Scholar
  21. 21.
    Chan PA, Robinette A, Montgomery M, Almonte A, Cu-Uvin S, Lonks JR, Chapin KC, Kojic EM, Hardy EJ. Extragenital infections caused by Chlamydia trachomatis and Neisseria gonorrhoeae: a review of the literature. Infect Dis Obstet Gynecol. 2016;2016:1–17.CrossRefGoogle Scholar
  22. 22.
    Trebach JD, Chaulk CP, Page KR, Tuddenham S, Ghanem KG. Neisseria gonorrhea and Chlamydia trachomatis among women reporting extragenital exposures. Sex Transm Dis. 2015;42:233–9.CrossRefGoogle Scholar
  23. 23.
    Marrazzo JM, Apicella MA. Neisseria gonorrhoeae (gonorrhea). In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s principles and practice of infectious diseases. Philadelphia: Saunders; 2016. p. 2446–62.e3.Google Scholar
  24. 24.
    Greydanus DE, Seyler J, Omar HA, Dodich CB. Sexually transmitted diseases in adolescence. Int J Child Adolesc Health. 2012;5:379–401.Google Scholar
  25. 25.
    Bruce AJ, Rogers RS. Oral manifestations of sexually transmitted diseases. Clin Dermatol. 2004;22:520–7.CrossRefGoogle Scholar
  26. 26.
    Carmine L, Castillo M, Fisher M. Testing and treatment for sexually transmitted infections in adolescents—what’s new? J Pediatr Adolesc Gynecol. 2014;27:50–60.CrossRefGoogle Scholar
  27. 27.
    Jenkins WD, Nessa LL, Clark T. Cross-sectional study of pharyngeal and genital chlamydia and gonorrhea infections in emergency department patients. Sex Transm Infect. 2014;90:246–9.CrossRefGoogle Scholar
  28. 28.
    Sanders EJ, Wahome E, Okuku HS, Thiong’o AN, Smith AD, Duncan S, Mwambi J, Shafi J, McClelland RS, Graham SM. Evaluation of WHO screening algorithm for the presumptive treatment of asymptomatic rectal gonorrhea and chlamydia infections in at-risk MSM in Kenya. Sex Transm Infect. 2014;90:94–9.CrossRefGoogle Scholar
  29. 29.
    Oda K, Yano H, Okitsu N, Chiba T, Hara Y, Kudo T, Ozawa D, Irimada M, Ohyama K. Detection of Chlamydia trachomatis or Neisseria gonorrhoeae in otorhinolaryngology patients with pharyngeal symptoms. Sex Transm Infect. 2014;90:99.CrossRefGoogle Scholar
  30. 30.
    Dosekun O, Edmonds S, Stockwell S, French P, White JA. Lymphogranuloma venereum detected from the pharynx in four London men who have sex with men. Int J STD AIDS. 2013;24:495–6.CrossRefGoogle Scholar
  31. 31.
    Barbee LA, Centor RM, Goldberger ZD, Saint S, Dhanireddy S. A history lesson. N Engl J Med. 2015;372:1360–4.CrossRefGoogle Scholar
  32. 32.
    Staikov IN, Neykov NV, Kazandjieva JS, Tsankov NK. Is herpes simplex a systemic disease? Clin Dermatol. 2015;33:551–5.CrossRefGoogle Scholar
  33. 33.
    Nakagawa H, Kuwuyama T, Ogawa K. Primary oropharyngeal herpes simplex virus infection in adults: a profile of thirty-two immunoserologically confirmed cases. Clin Otolaryngol. 2015;40:378–99.CrossRefGoogle Scholar
  34. 34.
    Prober CG. Herpes simplex virus. In: Long SS, Pickering LK, Prober CG, editors. Principles and practice of pediatric infectious diseases. 4th ed. Philadelphia: Saunders; 2012. p. 1026–34.Google Scholar
  35. 35.
    Chung CH, Bagheri A, D’Souza G. Epidemiology of oral human papillomavirus infection. Oral Oncol. 2014;50:364–9.CrossRefGoogle Scholar
  36. 36.
    Nguyen NP, Nguyen LM, Thomas S, Hong-Ly B, Chi A, Vos P, Karlsson U, Vinh-Hung V. Oral sex and oropharyngeal cancer: the role of the primary care physicians. Medicine. 2016;95(28):e4228.CrossRefGoogle Scholar
  37. 37.
    American Academy of Pediatrics. Screening for nonviral sexually transmitted infections in adolescents and young adults. Policy Statement Pediatrics. 2014;134:e302–11.Google Scholar
  38. 38.
    Center for Disease Control and Prevention. Special populations 2015 STD treatment guidelines-special populations [Internet]. 2015. Available at: Accessed 26 Aug 2016.
  39. 39.
    Giannini CM, Kim HK, Mortensen J, Mortensen J, Marsolo K, Huppert J. Culture of non-genital sites increases the detection of gonorrhea in women. J Pediatr Adolesc Gynecol. 2010;23:246–52.CrossRefGoogle Scholar
  40. 40.
    Lutz AR. Screening for asymptomatic extragenital gonorrhea and chlamydia in men who have sex with men: significance, recommendations, and options for overcoming barriers to testing. LGBT Health. 2015;2:27–34.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Emily Popler
    • 1
  • Judson J. Miller
    • 2
  1. 1.Pediatric Hospitalist, Floating Hospital for Children, Tufts Medical Center, Pediatrics, Division of Hospital MedicineBostonUSA
  2. 2.Department of PediatricsEmory University School of MedicineAtlantaUSA

Personalised recommendations