Tonsillar colonisation of Fusobacterium necrophorum in patients subjected to tonsillectomy.

Helena Björk,Katarina Hedin,Martin Sundqvist,Lena Bieber

doi:10.1186/s12879-015-0975-z

Abstract

BackgroundFusobacterium necrophorum is a well-known cause of Lemirre’s disease and accumulating evidence support its pathogenic role in peritonsillar abscess while its role in recurrent and chronic tonsillitis is uncertain. The objective of this study was to assess the prevalence of oropharyngeal colonisation with F. necrophorum and Beta-haemolytic streptococci in a cohort of patients scheduled for tonsillectomy due to recurrent or persistent throat pain, and to evaluate the dynamics of colonisation with repeated sampling during a follow-up time of 6 to 8 months.MethodsFifty-seven (57) patients aged 15–52 years scheduled for tonsillectomy due to chronic/recurrent tonsillitis or recurrent peritonsillar abscess were included. Throat swabs for the detection of F. necrophorum and Beta-haemolytic streptococci and clinical data was collected at inclusion, at the time of surgery and 6 to 8 months after surgery. Statistical analysis was performed using the Chi-square, Fisher’s exact and Mc Nemar tests.ResultsFusobacterium necrophorum was found in 28, 30 and 16 % of the patients at inclusion, surgery and follow up respectively. The corresponding results for beta-haemolytic streptococci were 5, 9 and 5 %. Patients colonised with F. necrophorum at follow-up, after tonsillectomy, were equally relieved from their previous throat pain as non-colonised patients. Looking at individual patients, the culture results for F. necrophorum varied over time, indicating a transient colonisation.ConclusionFusobacterium necrophorum was frequently found in throat cultures in this cohort of patients with recurrent or chronic throat pain leading to tonsillectomy. Colonisation was equally frequent in the asymptomatic cohort post-tonsillectomy, indicating that F. necrophorum is not alone causative of the symptoms. In an individual perspective, colonisation with F. necrophorum was transient over time.

Highlights

Fusobacterium necrophorum is a well-known cause of Lemirre’s disease and accumulating evidence support its pathogenic role in peritonsillar abscess while its role in recurrent and chronic tonsillitis is uncertain
The aim of the study was to assess the prevalence of F. necrophorum and beta-haemolytic streptococci in throat swabs of patients scheduled for tonsillectomy because of recurrent tonsillitis, peritonsillar abscess or chronic tonsillitis/ recurrent sore throat syndrome, and to compare this with the prevalence in the same patients at the time of surgery and 6 to 8 months postoperatively
Indications for tonsillectomy were: more than one peritonsillar abscess, recurrent tonsillitis with symptoms interfering with normal daily activities or chronic tonsillitis/persistent sore throat syndrome with symptoms interfering with normal daily activities

Summary

Introduction

Fusobacterium necrophorum is a well-known cause of Lemirre’s disease and accumulating evidence support its pathogenic role in peritonsillar abscess while its role in recurrent and chronic tonsillitis is uncertain. The anaerobic, pleomorphic Gram-negative rod Fusobacterium necrophorum has been suggested to play an important pathogenic role in acute and recurrent tonsillitis as well as in persistent sore throat syndrome [12,13,14,15]. It has likewise been put forward as a major pathogen in peritonsillar abscesses [4, 16]. Some recent studies [12, 18, 19] have not been able to detect the bacterium in throat swabs and tonsil core biopsies of asymptomatic subjects, while others [14, 20, 21] have reported a carriage rate of 3.5–21 % in healthy controls

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