AIM: Bacterial pharyngotonsillitis and tonsil hypertrophy are extremely frequent in childhood. This study aims to identify and verify the frequency of the bacterial colonization in tonsils of children with history of recurrent tonsillitis and tonsil hypertrophy. STUDY DESIGN: Clinical prospective. PATIENTS AND METHOD: Ninety children, both female and male, ages between 2 and 6 years (pre-school children) and 6 and 12 years (scholars) scheduled for adenotonsillectomy; 27 with history of recurrent pharyngotonsillitis (AR), and 63 with obstructive adenotonsillar hypertrophy (AO), assisted at Division of Pediatric Otolaryngology, Federal University of Sao Paulo, were evaluated from 1999 to 2002. Material from the surface of the tonsils was taken with swabs at the moment of the surgery. After tonsil removal, material was also taken from the tonsil core. The obtained material were submitted to culture and analyzed according to bacterial growth. RESULTS: Overall, regardless the age and the diagnostic group, the most prevalent pathogenic isolated bacteria were Haemophilus sp, 50.5% in the AO group and 59.2% in the group AR; S. Aureus, 50.7% in the AO group, and 33.3% in group AR; S pyogenes, 9.5% in the AO group and 7.4% group AR; S. pneumoniae, 4.7% in the AO group, and 0% in group AR; and Moraxella sp, 6.3% in the AO group and 11.1% in group AR. No significant difference was noted between the bacteria isolated from surface and the tonsil core. S aureus was more frequent in the AO group compared to the group AR in both, school children and scholars. Scholars presented higher incidence of S pyogenes in the AR group, and although also present in the pre-school children tonsils, it was only isolated in the AO group. S pneumoniae was only isolated in children with obstructive adenotonsillitis (AO). CONCLUSION: The results of our study suggest that the surface and core bacterial colonization of the tonsils is similar. It also seems that the prevalence of S pyogenes colonization is high, around 10%, and that S aureus is more prevalent in children with hypertrophic adenotonsillitis compared to the group with recurrent infections.
bacteriology; pharyngotonsillitis; tonsil hypertrophy
