Role of fine needle aspiration in isolating the core bacteria in children with recurrent tonsillitis

ABSTRACT

Fine needle aspiration [FNA] of the tonsil as a diagnostic tool in evaluating the micro flora in recurrent tonsillitis has not been popularized. A prospective study of 52 patients with recurrent tonsillitis undergoing tonsillectomy was undertaken. Their age ranged from 3 to 11 years. Surface swab and FNA were taken followed by tonsillectomy and the core tissue was sent for culture. No complications were recorded from the procedure of FNA. The correlation between culture results [for each of core, FNA and swab] and clinical or laboratory data [age, sex, number of attacks per year, HB%, TLC, ESR and CRP] were all insignificant with p value always >0.05. The reliability of the culture by Swab and FNA of the tonsil core was validated with the reference [gold] standard which is the dissected tonsil core. The sensitivity of FNA and swab cultures as compared to core culture was 83.3% and 62.1% respectively. The positive predictive value of FNA and swab cultures as compared with core cultures were 96.2% and 85.7% respectively. No significant correlation was observed between culture results and clinical and laboratory variables. No significant correlation was observed between age and type of organism. Our study showed that FNA of the tonsil core is reliable, safe and valid in identifying the bacterial organism within the infected tonsil for appropriate antibiotic therapy. The next step in evaluating this technique is to attempt it as an outpatient setting on children with recurrent tonsillitis under sedation/local anesthesia. As investigators become more experienced, sensitivity may increase. Accordingly; FNA of the tonsil core could revolutionize the management of patients with chronic tonsillitis