[Importance of anaerobic bacteria in recurrent childhood non-streptococcal tonsillitis].

BACKGROUND

The presence of anaerobes in the oropharyngeal flora was already known, but they were infrequently involved in infections, except for specific diseases (abscesses, Vincent's angina). The involvement of anaerobes in more frequent by observed oropharyngeal diseases has been recently proposed.

METHODS

We analyzed the tonsillar flora of 22 healthy children (control group) and 54 children diagnosed of recurrent tonsillitis. We compare the clinical response of children with recurrent tonsillitis to two treatments: penicillin, and penicillin plus metronidazole.

RESULTS

We isolated Streptococcus pyogenes from 22.2% of children with tonsillitis, and did not isolate it from any healthy children. The rest of tonsillar flora was qualitatively similar in both groups. Both populations showed a high proportion of beta-lactamase-producer bacteria. In children from whom S. pyogenes was isolated, the response to the treatment was similar for both treatments. In those cases where S. pyogenes was not isolated, penicillin + metronidazole cured the 77.2% of children treated, but penicillin cured only 30% of cases.

CONCLUSIONS

These results suggest that anaerobes might be involved, at least, in recurrent tonsillitis when S. pyogenes is not found, and justify further studies about the etiology and treatment of this disease.