Fine-Needle Aspiration as a Diagnostic Tool for Recurrent Tonsillitis

Abstract

Acute tonsillitis is a common childhood disease, but repeated antibiotic treatment may fail, leading to tonsillectomy. Superficial swab cultures do not sufficiently represent the core bacteria present, but fine-needle aspiration may be a promising diagnostic method. We evaluated 58 patients undergoing tonsillectomy, and took superficial and core swabs, and fine-needle aspirations. Staphylococcus aureus was the most common bacterial pathogen identified, present in 26 out of 50 (52%) positive core cultures, followed by Haemophilus influenza in 13 positive core cultures (26%), and group A beta-haemolytic streptococci in 10 positive core cultures (20%). Fine-needle aspiration detected 33 out of 50 positive core cultures (66%), whereas superficial swab culture detected 18 of 50 (36%); the difference being statistically significant. All pathogens detected by superficial swabs and fine-needle aspiration were detected in core cultures. The sensitivity and specificity of fine-needle aspiration were 66% and 100%, respectively, compared with 36% and 100% for superficial swabs. Fine-needle aspiration is therefore a promising method for detecting core bacteria in patients with recurrent tonsillitis.

Intracellular Persisting Staphylococcus aureus Is the Major Pathogen in Recurrent Tonsillitis

“…In fact, a number of studies have been conducted to elucidate the spectra of bacteria involved in causing PTA or RT. Haemophilus influenzae , Staphylococcus aureus , and Streptococcus pyogenes were - with varying relative proportions - the predominant species isolated from both patient groups (PTA: [4]–[9]; RT: [10]–[26]). Specifically in PTA patients, anaerobes were frequently found to accompany the aforementioned species.…”

“…Astonishingly little differences were seen between these groups of patients. In RT patients, also the efficiency of different approaches for material collection was compared by employing superficial swabs from the tonsillar surface or the pharyngeal wall vs. fine needle aspirations or surgically prepared tonsillar core [12]–[16], [21], [23], [24], [26]. With the exception of Haemophilus influenzae more frequently isolated from the tonsillar core, again little differences could be established between the compared groups.…”

Evaluation of microbial flora in chronic tonsillitis and the role of tonsillectomy

“…Fine needle aspiration and culture has shown close correlation with the tonsil core bacteria which is far superior to the surface swab 11,12 . In this series, fine needle aspiration of tonsils was done under anesthesia and was not attempted in the out patient setup.…”

Current Trends of Surface Versus Core Bacterial Flora among Recurrent Tonsillitis Patients in a North Indian Tertiary Care Hospital

“…4 Several researchers have claimed that the failure of antibiotic therapy may be due to the underestimation of resistant microorganisms. 5 Tonsillectomy and adenoidectomy done because of recurrent infection or obstruction are amongst the most frequently performed childhood operations. Tonsils and adenoids which play a protective role against infections in healthy individuals may become a reservoir for pathogenic microorganisms in case of chronic infections.…”