ABSTRACT
Chronic infection in childhood is a leading cause of adeno-tonsillectomy. The aim of this study was to determine the role of M. pneumoniae in children with rhino sinusitis and adenoid hypertrophy. This case - control study was carried out in the pediatric and ENT wards of Hazrat Rasul Hospital, Tehran, Iran [2007-2009]. In this trial, we investigated 40 cases with adenoid surgery and 32 controls.We looked for M pneumoniae -DNA [PCR] in adenoid tissues resected from cases and 31 nasopharyngeal swabs in controls and IgM and IgG antibodies [ELISA] were compared between the 2 groups, P < 0.05 was considered to show a significant value. Positive PCR results were observed in 35% of cases and none of controls, positive-IgG was seen in 20% of cases and 6.4% of controls [P = 0.71] which was higher in older cases [6 vs. 4 years, p < 0.05]. Positive -IgM was seen in 10% of cases vs. 9.7% of controls, [P = 0.74]; without any difference for age [6.2/ 5.3 years, p = 0.1]. A positive PCR result was not related to positive IgG [p = 0.014], but to a positive IgM [p = 0.1]. M. pneumoniae infection was found serologically [IgM and IgG] in 10% and 20% of cases, respectively. These numbers along with positive PCR in adenoid tissue of cases [30%] indicates the prominent role for M pneumoniae in adenoid hypertrophy. We concluded that children in Iran will have been infected with M pneumoniae and would have obtained immunity between the ages of 6 and 8. Adenoid tissue might act as a reservoir for M. pneumoniae and cause rhino sinusitis concomitant with adenoid hypertrophy in infected children. Theoretically, suitable M pneumoniae eradicating antibiotics before adenoid surgery [with rhino sinusitis or chronic ear infection] might be helpful treatment, but it needs future RCT studies to be proven