Predisposing Factors and Change of Organism Strains that Cause Severe Acute Tonsillitis

Lee, Kang Won; Hong, Young Ho; Kim, Chun Gil; Paik, Sang Heum; Mun, Seog Kyun; Seo, Kang Wook

Abstract

BACKGROUND AND OBJECTIVES
Acute tonsillitis is a clinical condition of gross tonsillar infection. Since previous studies focused on immunology of tonsils and group A beta-hemolytic streptococcus, we have not had sufficient clinical analyses of acute tonsillitis, such as predisposing factors and change of organism strains causing tonsillitis. This study aims to explain many factors that seem to be related to severe acute tonsillitis, such as age, sex, seasonal distribution, days from initial symptoms to visit, body temperature, symptoms, past history, duration of hospitalization, number of patients of culture positive group, culture organisms and antibiotic sensitivity of common organism strains. SUBJECTS AND METHOD: In this study, researchers clinically reviewed 283 patients who were hospitalized at the Chung-Ang University Hospital at any time from January 1993 to December 2002. Throat smear was done at the surface of inflammed tonsils. RESULTS: Among 283 cases, 125 cases yielded pus plug. Seven strains of bacteria were isolated in 115 culture-positive cases. There were significant differences between Group A (from January 1993 to December 1997) and Group B (from January 1998 to December 2002) regarding organism strains isolated. In both Group A and B, group A beta-hemolytic streptococcus was the most common organism that caused severe acute tonsillitis. However, in Group B, other organism strains, such as Pseudomonas aeruginosa and Enterococcus, increased in number and in their resistance to penicillin and cephalothin. The researchers found no predisposing factors that were related to severe acute tonsillitis. CONCLUSION: To sum up, this study demonstrates that we may reconsider the use of antibiotics such as penicillin and cephalothin for severe acute tonsillitis. This study calls for further studies about the change of organism strains that cause severe acute tonsillitis and about the predisposing factors that affect severe acute tonsillitis.