Difference in microbiology between superficial and deep tissue in cases of tonsillitis

ABSTRACT

This study was designed to examine the bacteriology of the superficial surface and deep tonsillar core of 60 patients suffering from recurrent tonsillitis with particular reference to the causative aerobes. The commonest preoperative superficial tonsillar swabs were B-hemolytic streptococcus from 21 cases [35%], Staphylococcus aureus from 15 cases [25%] and Hemophilus influenza from 9 cases [15%], while the commonest organisms isolated from the deep tonsillar surface were B-hemolytic streptococcus from 13 cases [21.66%], Staphylococcus aureus from 11 cases [18.33%], Hemophilus influenza from 10 cases [16.66%]. Thus, this study indicated that a superficial throat swab is a very poor indicator of the type of infection, since the pathogenic flora inside the tonsil is different from that in the surface. A surface throat swab fails to detect the organism in a large number of cases, especially where the infection lies deep inside. Deep tonsillar microflora have to be considered as a very significant factor in recurrent tonsillitis. So, it is necessary to recognize the deeply seated pathogens when selecting antibiotic therapy for patients with recurrent tonsillitis