BACTERIOLOGY AND IMMUNOLOGY OF NORMAL AND DISEASED ADENOIDS IN CHILDREN

Adenoid physiology as reflected in the qualitative and quantitative ba cteriology and immune cell distribution was correlated with clinical p resentation in 69 children (16 to 130 months of age) undergoing adenoi dectomy for obstructive adenoid hyperplasia (n=38) or chronic adenoid infection (n=31) and in 16 adenoid core biopsy specimens from 16 nondi seased controls. In the control adenoids, few potentially pathogenic b acteria were found as the dominant bacteria in the adenoid core (25%), and significantly greater concentrations of nonpathogens (commensals) were isolated (P<.01). Potential pathogens as the dominant bacteria w ere found twice as often in obstructive adenoid hyperplasia (62%) and in chronic adenoid infection (55%) (P<.05). Haemophilus influenzae was most common in the diseased adenoids, 53% in obstructive adenoid hype rplasia and 48% in chronic adenoid infection, compared with only 19% i n the controls (P<.05). No significant differences in lymphocyte densi ty, B and T cells, as well as T-helper subsets, were found between cli nical classifications. However, T-suppressor cells, monocytes-macropha ges, and natural killer cells were significantly increased in chronic adenoid infection only (P<.05). The findings in this study support rol es for both alterations in bacterial homeostasis and an altered immune profile in the etiology of chronic adenoid disease in children.