Israr Ahmad, Muhammad Saeed Anwar, Khalid Naeem, Javaid Iqbal, Muhammad Ashiq Hussain.
Surface vs core Tonsillar Aerobic and Anaerobic flora in recurrent tonsillitis.
Pak Paed J Jan ;22(4):185-8.

Specimens from both surface and core of tonsils from 40 children With recurrent tonsillitis were cultured for both aerobic and anaerobic bacteria. The predominant is isolates were Bacteroides sp and anerobic streptococci. The principal aerobic isolates were abemoytlic streptococci. staphylococcus aureus and neisseria spp. Aerobic isolates also included hemophilus and pseudomonas. The tonsil surface reflected mainly the normal flora of the oropharynx, whereas tonsil core showed growth of organisms like hemophilus and staph aureus which was rarely reflected in the surface culture. 32.3% aerobic isolates were recovered from both surface and core specimen. compared with 27.2% of anaerobic isolates. 19.5% of the aerobes were recovered from the core only compared with 57% of the anaerobes and 48% of the aerobes on the surface compared with 16% of the anerobes. The data clearly demonstrates the discrepancy between the surface and core culture of the tonsils in recurrent tonsillitis and therefore very genuinely questions the value of the surface culture in predicting the real pathogens in recurrent tonsillitis.

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