Title: Comparative Study of Surface and Core Microflora of Chronic Tonsillitis
Authors: Rajesh K, Prabhusaran N*, Sahoo GC, Prabhakar K, Jesudoss A
DOI: http://dx.doi.org/10.18535/jmscr/v4i4.14
Abstract
The main objective of this study is to find the correlation and differences between the microflora isolated and characterized from the surface and core regions of the tonsils, where the subjects were initially defined as tonsillitis. The maximum age incidence was from 6 to 12 years where the sex incidence was more in females than males. In majority of the patients, jugulodigastric nodes are palpable where the squeeze test was positive to 22% of cases. Sore throat and odynophagia are the symptoms predominantly found and these were presented with 2 to 3 years of duration among maximum cases, where in the average duration was 1 year and 7 months. Majority of the patients had chronic parenchymatous tonsillitis but enlarged adenoids were the most commonly associated ENT condition. Among the bacterial isolates, 87% was possible to aerobic isolation whereas 13% possibility was for both aerobic and anaerobic bacterial members. In the surface region, β haemolytic streptococci and Staphylococcus aureus are predominant isolates whereas in core region, β haemolytic streptococci and Streptococcus pneumoniae are possible. The variations in the bacterial isolates were possible maximum in core region compared to surface. Bacteriodes was the common anerobe found in both core and surface but dominance of Fusobacterium was identified in surface area only. The raised ASO titre was found in majority of the patients. Norfloxacin and ciprofloxacin are the common and routine antibiotic classically found effective against the isolates that re-establishing the superiority of the newer generation antibiotics to traditional penicillin.
Keywords: Chronic tonsillitis, Bacteriological investigation, surface, core, comparativeness.
References
1. Abhay K, Vaishali G, Kamiesh C, Gupta P, Saurabh V. Clinico bacteriological evaluation of surface and core microflora in chronic tronsillits. Ind J Otolaryngol Head Neck Surg 2005; 57: 118-120.
2. Ahmary MA, Mastour AA, Ghnnam W. The microbiology of tonsils in Khamis civil hospital, Saudi Arabia. ISRN Otolaryngol 2012; 2012: 581-583.
3. Anand VT, Phillips JJ, Allen D, Joynson DH, Fielder HM. A study of postoperative fever following pediatric tonsillectomy. Clin Otolaryngol 2009; 24: 360-364.
4. Davis DJ. Bacteriology and pathology of the tonsils with special reference to chronic articular, renal and cardiac lesions. J Infect Dis 1912; 10: 148-161.
5. Elsherif AM, Abdelrahman YO, Mostafa AH, Nahla ME. Discrepency between tonsillar surface and core culture in children with chronic tonsillitis and incidence of post tonsillectomy bacteraemia. AAMJ 2011; 9: 171-182.
6. Jeong JH, Lee DW, Ryo RA, Lee YS, Lee SH, Kang JO, Tae K. Bacteriologic comparison of tonsil core in recurrent tonsillitis and tonsillar hypertrophy. Laryngoscope 2007; 117: 2146-2151.
7. Kaygusuz I, Gok U, Yalcin S, Keles E, Kizirgil A, Demirbag E. Bacteraemia during tonsillectomy. Int J Pediatr Otolaryngol 2001; 58: 69-73
8. Lintroos R. Bacteriology of the tonsil core in recurrent tonsillitis and tonsillar hyperplasia – a short review. Acta Otolaryngol Suppl 2000; 543: 206-208.
9. Loganathan A, Arumainathan UD, Raman R. Comparative study of bacteriology in recurrent tonsillitis among children and adults. Sing Med J 2006; 47: 271-275.
10. Rajesh K, Prabhusaran N, Sahoo GC, Prabhakar K, Jesudoss A. Prevalence of bacterial pathogens and its relative distribution in various chronic tonsillitis. Med Sci 2016; 20: 62-68.
11. Wiatrak BJ, Woolley AL. Tonsil and Adenoids: In pediatric Otolaryngology Head and Neck Surgery. 6th. edition. Richardson MA (Ed.), Chales CW et al. (Gen. Eds.) Mosby-year book. Inc. St. Louis. 2008: 188-205.
12. Yildirim I, Okur E, Ciragil P, Aral M, Kilic A, Gut M. Bacteraemia during tonsillectomy. J Laryngol Otol 2003; 117: 619-623.
13. Zalzal GH. Adenotonsillar disease. J Med Liban 1994; 42: 230-234.