Chlamydia in the Throat… Really?

What is throat chlamydia?

Throat chlamydia is when the bacterial infection, chlamydia trachomatis, is present in the throat. It infects the cellular lining in the throat and mouth and is referred to as oral chlamydia.

How do you get it?

Throat chlamydia is contracted by giving oral sex to a person who is infected with chlamydia. You cannot get oral chlamydia from kissing someone else who has chlamydia in their throat.

By the same token, if you receive oral sex from a person with oral chlamydia, you are at high risk of developing genital chlamydia.

How do you know if you have chlamydia in your throat?

To know you have chlamydia in your throat you will need to take a chlamydia test. The symptoms of throat chlamydia are similar to other infections that can affect the throat, and a test is the only way to confirm if you have the infection or not. Tests are available free at sexual health clinics, genitourinary medicine (GUM) clinics or a GP surgery. You can also get a home test kit.

Often people with genital chlamydia will be asked to provide a urine sample. Chlamydia in the throat can only be diagnosed using a throat swab. This involves gently wiping a small cotton bud over the infected part of your throat or mouth. This sample is sent to a laboratory to test for the bacteria. If the result is positive, the person should start treatment and let any recent sexual partners know.

What are the symptoms of chlamydia in the throat?

Often, chlamydia is an asymptomatic infection. This means it shows no symptoms so you could have chlamydia and not know.

Early chlamydia in the throat will often present as a sore throat. However, this is often dismissed as a common cold or viral. A sore throat is often accompanied by other symptoms of chlamydia.

Other symptoms of chlamydia in the throat can include:

• Redness, pain or inflammation around the mouth and throat
• Sores around the mouth and lips
• Dental issues
• Swollen lymph nodes

• Bumps on the tongue
• White spots towards the back of the throat and tonsils
• Low grade fever

If you have engaged in penetrative sex with an infected person, you may also experience other symptoms of chlamydia including:

• Painful urination
• Unusual discharge from the penis, vagina, or anus
• Stomach or pelvic pain and bleeding between periods and after sex in women
• Pain or swelling of the testicles in men
• Rectal pain

Are bumps on the tongue a sign of oral chlamydia?

Yes, bumps on the tongue are a sign of oral or mouth chlamydia. You may also notice white spots in the back of your throat or tonsils. If you have either of these symptoms, you should get tested for oral chlamydia (especially if you have recently engaged in unprotected sexual activity).

Can you tell if you have it from pictures?

A simple google search of “oral chlamydia” or “throat chlamydia” will bring up pictures of spots towards the back of the throat and bumps on the tongue.

However, these symptoms are also similar to other conditions such as oral thrush, a streptococcus infection, tonsillitis and mononucleosis.

It can therefore be difficult to tell if you have oral chlamydia from pictures. You should get tested for chlamydia if you think you have it.

Does throat chlamydia go away?

Throat chlamydia will go away by itself without treatment in around 50% of people. In instances where the infection does not clear itself, it can present with serious health complications if chlamydia treatment is not sought.

What is the treatment for oral chlamydia?

Oral chlamydia is treated with the antibiotics, azithromycin or doxycycline. Doxycycline is the recommended treatment as it is more effective. Chlamydia antibiotics come as oral tablets or pills that are swallowed with water.

It is important that you use chlamydia treatment if you have tested positive. According to the NHS, more than 95% of chlamydia cases are curable if the medication is taken correctly. These antibiotics work by slowing or stopping bacterial growth and this cures the infection, reducing the risk of transmission.

If you are diagnosed with chlamydia of the throat, you should wait until you finish your prescribed dose and your symptoms have completely gone before engaging in sexual activity.

Do not stop your course of antibiotics early, even if your symptoms improve or go away. This could cause the infection to come back.

Can I catch it from kissing an infected person?

No, you cannot get throat chlamydia from kissing an infected person.  

The most common way that you can contract throat chlamydia is by having unprotected oral sex with someone who has the infection.

How can I prevent catching oral chlamydia?

There are risk factors that increase your chances of getting chlamydia. These include:

• Being sexually active and under age 25
• Having multiple sexual partners
• Not using barrier methods
• Having a history of sexually transmitted infection

There are certain steps you can take to prevent catching oral chlamydia including:

• Using condoms for mouth to penis contact
• Using a dam during mouth to vagina or oral-anal contact
• Talking to your sexual partner about their sexual health
• Using barrier methods, such as condoms, during each encounter
• Having a regular sexual health check or STI tests, especially if you have unprotected sex with a new partner

The recurrence rate of chlamydia is particularly high. This makes it even more important to practice safe oral sex and prevent future infections.

What is the difference between chlamydia in the throat and streptococcus infections?

Both chlamydia in the throat and streptococcus (strep) throat are bacterial infections that affect the mouth and throat area.

The main difference is that they are caused by a different bacterium. Chlamydia is caused by the bacteria called chlamydia trachomatis and strep throat is caused by bacteria streptococcus pyogenes.

This means that although they share some of the same symptoms, such as pain and soreness in the throat, inflammation of the lymph nodes and fever, they also have symptoms that differ. For example, chlamydia often presents as white spots towards the back of the throat and strep throat causes red spots. Aside from this difference, it’s difficult to distinguish the difference between the two.

A swab test is required to accurately diagnose both.

Chlamydia is treated using either doxycycline or azithromycin, and strep throat infections are treated using penicillin and erythromycin antibiotics.

What other STIs causes a sore throat?

Many other STIs as well as chlamydia can cause a sore throat.

Gonorrhoea

This is a common STI caused by the bacterium Neisseria gonorrhoeae. It affects your throat, genitals, urinary tract, and rectum. Like chlamydia, it can be passed on via oral sex and often doesn’t show any symptoms. When symptoms do appear, it’s usually a week after exposure and can include a sore throat. Gonorrhoea can be cured with antibiotics. You can test for gonorrhoea by taking a gonorrhoea test, which involves providing a urine sample.

Syphilis

This STI is caused by the bacterium Treponema pallidum. It is less common compared to other STIs. It affects your mouth, lips, genitals, anus and rectum and can spread to other parts of your body, including blood vessels and the nervous system, if it isn’t treated. This can lead to serious health problems such as organ damage and significant neurological conditions.

Syphilis follows three stages and you may get a sore throat in the second stage. It can be treated with antibiotics.

HSV in the throat

There are two types of the common herpes simplex virus (HSV-1 or HSV-2). These STIs can affect the throat and cause a condition called herpes esophagitis or herpes in the throat. A sore throat is a symptom of HSV in the throat. This is a lifelong condition. Treatment can reduce, prevent, or shorten the frequency of herpes outbreaks.

HPV

HPV is a very common STI. It affects the mouth, throat, genitals, cervix, anus, and rectum. HPV can spread via oral, vaginal, or anal sex. With oral HPV, you may get a sore throat that won't go away. HPV does not have a cure. However, it is often cleared by the body on its own without causing problems. Long term problems with HPV include an increase in likeliness of developing cervical cancer. There is a vaccine available to help prevent against HPV.

HIV

HIV (human immunodeficiency virus) is a virus that damages your immune system cells and weakens your ability to fight everyday infections and disease. It can cause a sore throat and flu-like symptoms that last for a couple of weeks. Symptoms eventually subside, but the virus can continue to damage your immune system. Antiretroviral medicines treat HIV by stopping the virus replicating in the body, allowing the immune system to repair itself, and prevent further damage.

In summary

Chlamydia in the throat is not common. Most frequently, throat chlamydia is passed on from the genitals to the throat. It can also spread via oral contact with the anus of an infected individual.

Barrier methods including condoms and dams are the best forms of prevention when having oral sex. It is recommended that you have regular STI checks regularly.

A short course of antibiotics can treat chlamydia. Reinfection rates are high so you should take precautions.

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.