QUANTITATIVE BACTERIOLOGY OF TONSILS REMOVED FROM CHILDREN WITH TONSILLITIS HYPERTROPHY AND RECURRENT TONSILLITIS WITH AND WITHOUT HYPERTROPHY

The aerobic and anaerobic bacterial species and their numbers were stu died in tonsillar specimens from children who had undergone elective t onsillectomy: 6 patients with recurrent tonsillitis (RTH), 9 with recu rrent tonsillitis with hypertrophy (RTH), and 8 with obstructive tonsi llar hypertrophy (OTH). Mixed flora were present in all tonsils, yield ing an average of 6.7 isolates (5.6 aerobic or facultative and 1.1 ana erobic bacteria). The highest recovery rate of organisms per tonsil wa s in patients with OTH (7.7 per tonsil), compared to 6.3 per tonsil in RT and 5.9 per tonsil in RTH. The predominant aerobic and facultative organisms were Haemophilus influenzae (22 isolates), Neisseria sp (16 ), Staphylococcus aureus (14), and Eikenella corrodens (14), and the p redominant anaerobic bacteria were Fusobacterium sp (8), Bacteroides s p (7), and Prevotella melaninogenica (5). The number of bacteria per g ram of tonsillar tissue varied between 10(4) and 10(8). A higher conce ntration of S aureus and H influenzae was found in hypertrophic tonsil s (RTH and OTH) as compared to RT. These findings suggest the presence of an increased bacterial load and supports an etiologic role for H i nfluenzae and 5 aureus in hypertrophic tonsils with and without inflam mation (RTH and OTH). Further studies to elucidate the effect of selec tive antimicrobial therapy directed at these organisms may offer an al ternative management of hypertrophic tonsils.