Abstract
Oral fungal infections are common opportunistic infections that may take different forms. Fungal infection as a cause of chronic tonsillitis indicates tonsillectomy as treatment, so preoperative identification of fungal causes of tonsillitis is valuable. Objectives: The aim of this study was to assess the incidence of fungal infection in chronic tonsillitis using preoperative microbiological basis and post-tonsillectomy histopathological basis. Methodology: This study included 75 children (patients group) suffering from chronic tonsillitis, and 15 healthy children complaining from obstructive sleep apnea (OSA) and snoring with no history of chronic tonsillitis. Each child subjected to full history taking, clinical examination and preoperative investigations. Tonsillar swabs were taken from each tonsil of all subjects. Smears were stained and examined microscopically then cultured using Sabouraud dextrose agar (SDA). Post-tonsillectomy, histopathological examination was carried out. Results : Tonsillomycosis is significantly associated with dental caries and recurren acute attacks of tonsillitis (with p=0.004 & 0.001respectively). Hypertrophic tonsil and neutropenia are significantly detected in tonsillomycosis (p=0.001 for both). A histopathological examination found that fungal invasion of tonsillar tissue was found in about 31.3% of tonsils (47/150) with immune reaction and presence of chronic inflammatory cells. Preoperative microbiological work revealed tonsillomycosis in 45/150 (30%) of tonsils. In comparison to histopathology, microbiological examination had 95.9% sensitivity, 100% specificity, 100% PPV and 98.1% NPV. Conclusion : Fungal infection is a common cause of chronic tonsillitis. Haphazard use of antibiotics and dental caries has a significant predisposing role in tonsillomycosis. Neutropenia and hypertrophic tonsils can be taken as an indicator for tonsilar fungal infection. Microbiological examination is valid for preoperative diagnosis of tonsillomycosis.
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