ABSTRACT
Group A ß-hemolytic streptococci (GABHS) is the most frequent bacterial cause of acute suppurative tonsillitis. Antimicrobial agents are required only in the bacterial acute suppurative tonsillitis. So it becomes must to determine the cause of acute suppurative tonsillitis and to institute the appropriate antibiotic therapy thus avoiding use of costly antibiotics in case of nonbacterial etiology. In our study 44 children were diagnosed as having acute febrile suppurative tonsillitis with the etiologies of Gr. A streptococci, adenovirus and Epstein-Barr (EB) virus. There were 20 cases of adenoviral tonsillitis, 15 cases of Epstein- Barr viral tonsillitis and 09cases of Gr. A Streptococcal tonsillitis. The aim of this study was to find out whether the serum C-reactive proteins (CRP), peripheral WBC counts and the age of the patient could make an influence in differentiating the etiological agent in acute tonsillitis. There was no significant difference between adenoviral and streptococcal groups, in the measurement of serum (CRP) or peripheral WBC count. Patients with Gr. A streptococcal tonsillitis were significantly older than EB-viral or adenoviral tonsillitis (p < 0.05).Sixty six per cent of patients with adenoviral tonsillitis were under 4 years of age, 67% of the patients with EB-viral tonsillitis were under 6 years of age, whereas 71% of the patients with streptococcal tonsillitis were over 6 years of age. Based on clinical examination, serum CRP and peripheral WBC cannot differentiation between bacterial or viral cause of acute suppurative tonsillitis whereas age was clearly the most important factor.