Clinical Bacteriological Evaluation of Tonsillar Surface and Core Microflora in Recurrent Tonsillitis Undergoing Tonsillectomy

Background: Clinically, chronic/recurrent Tonsillitis the most common disease is indistinguishable whether viral or bacterial etiology. Effective treatment of the tonsillitis depends on knowledge of the infecting organism, but there is always a dilemma whether the antibiotics prescribed for the tonsillitis are sufficient for the different organisms in the surface and core of the tonsils. Aim of study: To determine the bacterial flora in the tonsillar core and compare it with tonsillar surface organisms, whether there is any difference between tonsillar surface and deep tissue cultures, and to correlate the clinical profile of the patients with various microorganisms. Methods: This prospective study was performed on (57) patients clinically diagnosed with recurrent tonsillitis/ Adeno-tonsillar hypertrophy, who underwent tonsillectomy, aged from (4) years to(37) years, admitted in the Otorhinolaryngology department, Surgical Specialty Center, University of Benghazi from 1st January to 31st December 2022. Tonsillar surface and core tonsillar cultures were taken and isolated. Result: The bacterial flora of the tonsil surface and core was compared. Pathogens were isolated by core culture but not by the surface culture in 14 cases (25%). In 34 cases (59.64%), pathogenic microflora were identified from the core of tonsils, differing from the surface. Discrepancy between surface and core culture as to the presence or absence of core pathogens was in (46) cases (81%), while it was identical in (11) cases (19%). Staphylococcus aureus was the most common isolated organism in the surface and core of the tonsil. Conclusion: Most bacteria are embedded in the core of the tonsil rather than the surface of the tonsil. Staphylococcus aureus was the most common isolated organism in the surface and core of the tonsil.