Tonsillar Crypts Research Articles

Histomorphological evaluation of thermal injury following palatoplasty performed with CO2 laser or LigaSure device in dogs with brachycephalic obstructive airway syndrome

The elongated soft palate is an abnormality that characterizes most brachycephalic dogs and contributes to the brachycephalic obstructive airway syndrome (BOAS). Palatoplasty is routinely performed in brachycephalic dogs; several surgical techniques exist. The use of surgical instruments such as monopolar electrocoagulation, CO2 or diode laser, bipolar vessel sealing device and harmonic shears has become routine to reduce the operating time, the intraoperative risk of bleeding and the postoperative oedema. This prospective study aimed to compare the histomorphological effect of a CO2 laser and LigaSure device in palates of dogs undergoing palatoplasty. Twenty owned brachycephalic dogs were included, 10 palatoplasties were performed using CO2 laser and 10 using LigaSure™ device. The dogs were positioned in sternal recumbency. A transoral approach was performed: the elongated soft palate was grasped with Allis forceps and brought rostrally, the palatoplasty was performed using the tonsillar crypts as anatomical landmarks. Surgical specimens were routinely fixed in 10 % formalin. Two sections perpendicular to the surgical margins were trimmed from each sample, paraffin-embedded and stained with hematoxylin and eosin (H&E). Tissue damage induced by the two types of surgical devices was graded (1–4, from minimal to severe) and the depth of thermal injury measured in μm on captured images (using an image analysis program - ImageJ). Mean values and standard deviations (SD) were calculated based on six measurements for each sample.The tissue damage was graded 3.7±0.48 in group LigaSure™ and 2.8±1 in group Laser. The mean depth of thermal injury was 874.94±184.92 μm in the LigaSure™ group and 451,76±137,86 μm in the Laser group. The comparison between the two groups showed significant lower grade and extension of thermal injury in the palate samples obtained with CO2 laser (p<0.05).Additionally, there is a lack of literature that correlates the histological changes with the clinical outcomes of the different palatoplasty methods in brachycephalic dogs. By comparing histological changes and clinical outcomes, we aim to provide valuable insights for optimizing the surgical approach for palatoplasty in brachycephalic dogs, ultimately improving postoperative outcomes for these patients.

6 Year Girl with Acute Exacerbation of Chronic Tonsillitis with Adenoid Hypertrophy

Acute bacterial tonsillitis is an acute inflammation of the palatine tonsils caused by viral and bacterial infections. The main causative viruses are Epstein bar virus, H. influenzae virus, and Coxsackie virus. Tonsillitis is most common in children but rare in children &lt; 2 years old. Adenoid hypertrophy is an obstructive condition associated with an increase in the size of the adenoids. This condition may occur with or without acute or chronic adenoid infection. The problem is described using descriptive case study method, starting from history taking, physical examination, supporting examination, diagnosis, to qualitative intervention management given to the patient. A case of a six-year-old girl with complaints of fever, nausea, and vomiting since six days before admission to the hospital is reported. Complaints were accompanied by pain when swallowing and a lump in the throat. History of recurrent cough and cold for about six months. For about two months, complaints of snoring at night that disturbed the patient's sleep. The patient also complained that sometimes his nose felt full. On physical examination, the throat mucosa was found to be pink, palatine tonsils T4/T4 and hyperemic, tonsil crypts were wide, and the pharynx and adenoids were difficult to assess. On supporting examination, adenoid hypertrophy was found. The patient was then diagnosed with Acute Exacerbation of Chronic Tonsillitis with Adenoid Hypertrophy and given therapy such as ceftriaxon inj 1gr IV 2x600mg, cetirizine syr 2x1cth, methylprednisolone inj IV 3x25mg. After control a week later, the patient's condition showed significant changes, and complaints were reduced a lot.

Sebuah Kasus : Post Tonsilektomi Dengan Komplikasi Syok Hipovolemik

Tonsillitis is inflammation of the palatine tonsils. Infection of the tonsils occurs if antigens, whether inhaled or ingested, easily enter the tonsils and the body resists and a focus of infection forms. Initially, the infection is acute, generally caused by viruses that grow on the mucous membrane, then followed by bacterial infection. As a result of chronic inflammation, the size of the tonsils will increase due to parenchymal hyperplasia or fibrinoid degeneration with tonsillar crypt obstruction. The definitive treatment for chronic tonsillitis is surgical removal of the tonsils or tonsillectomy where one of the complications is bleeding which triggers hypovolemic shock. This case report presents a 19 year old man who complained of pain in swallowing and a feeling of lump in the throat and based on the history, physical examination and supporting examinations that had been carried out, the patient was diagnosed with tonsillitis and planned to undergo a tonsillectomy. After the procedure, the patient experienced hypovolemic shock due to bleeding and died

Morphology of the soft palate and palatine tonsil of the goat (Capra hyricus).

The present study was carried out to study the morphology of the goat's soft palate and palatine tonsil by gross anatomy, morphometry, light and scanning electron microscopy (SEM). Twelve heads of normal adult (18-24 months) apparently healthy goats of both sexes were collected from local commercial slaughterhouses in Qena Governorate, Egypt. The oral cavity was dissected, and samples were collected for both light and SEM. The soft palate of the goat formed the caudal continuation of the hard palate. It was relatively short, it extended from the level of the caudal border of the last upper molar tooth to terminate caudally against the base of the epiglottis. The oral mucous membrane of the soft palate was covered by non-keratinized stratified squamous epithelium. The lamina propria and submucosa contained connective tissue fibers, diffuse and nodular lymphatic tissue, striated muscle fibers, and a large number of mucous and serous palatine glands. By SEM, the ventral surface had several rounded openings occupied by flower-like structures. These openings represented the entrances to the palatine glands. The palatine tonsil was large and protruded from a fossa in the lateral wall of the oropharynx. It had 2-3 elongated irregular openings that lead to the underlying crypts. These crypts were well-developed and lined by non-keratinized stratified squamous epithelium. The epithelium of the tonsillar crypts directly covered lymphoid tissue and was infiltrated by lymphocytes. Tonsillar glands of pure mucous type were demonstrated. In conclusion, the study provides the basic morphological features of soft palate, as well as the palatine tonsil of the goat by gross observation, light and SEM. The palatine tonsils of goat were well-developed with extensive crypt system, suggesting their essential role in the immunological response against antigens that enter through the oral cavity. The current findings may be useful to understand the role of the palatine tonsil in immunity and disease pathogenesis. RESEARCH HIGHLIGHTS: The study reported the basic morphological features of soft palate and palatine tonsil of goat. The ventral surface of the soft palate had several rounded openings occupied by flower-like structures. The palatine tonsils of goat were well-developed with extensive crypt system. The findings might help to understand the role of the palatine tonsil in immunity and disease pathogenesis.

Correlation Between Age and Tonsil Size in Patients with Chronic Tonsillitis at Aek Kanopan District General Hospital, North Sumatra

Abstract: Background: Chronic tonsillitis is inflammation of the tonsils that persists as a result of repeated acute or subclinical infections. The size of the tonsils in chronic tonsillitis is enlarged due to parenchymal hyperplasia or fibrinoid degeneration with obstruction of the tonsillar crypts. Based on data from the Indonesian Ministry of Health in 2012, the incidence of tonsillitis in Indonesia is around 23%. Young age predominates in the characteristics of tonsillitis patients. Objective: The research was to determine the correlation between age and tonsil size in chronic tonsillitis at the Aek Kanopan District General Hospital, North Sumatra. Method: This study uses secondary data, namely medical records at Aek Kanopan Hospital, North Sumatra. Research and data collection were carried out in November 2022 - February 2023. This research is an analytical study. The population is chronic tonsillitis patients at the ENT-KL installation at Aek Kanopan Hospital, North Sumatra, totaling 70 patients. Data analysis was univariate presented in the form of a frequency distribution table and bivariate analysis using a correlation testspearman rho by using SPSS version 24.0. Results: Based on the study, as many as (57.6%) were women and (42.4%) were men, most were aged &lt;18 years, namely (72.7%), mostly with hypertrophic tonsil sizes, namely (65.2%) and there were Correlation between age and tonsillitis size in chronic tonsillitis at Aek Kanopan District General Hospital, North Sumatra, p=0.000 (p&lt;0.05). Conclusion: There is a correlation between age and tonsillitis size in chronic tonsillitis at the Aek Kanopan District General Hospital, North Sumatra.

Conditions of Halitosis in Patients with Tonsillitis

Tonsillitis (Tonsillitis) is a condition caused by trapped plaque which is formed from the accumulation of sulfur-producing bacteria, fungi, sloughed off cells, and food debris that sticks to the palatine tonsillar crypts. This plaque can cause bad breath (halitosis). Purpose: to determine the impact of patients with tonsillitis (tonsillitis) on halitosis. Methods: This literature study uses Narrative Review by analyzing various journals from the online database BMC Oral Health, PubMed, and Google Scholar which are related to Halitosis in Tonsillitis sufferers. Results: Within two weeks of Tonsillitis treatment, the halitosis was excavated and disappeared. Conclusion: Tonsillitis is one of the causes of bad breath. Actions applied are Tonsillitis removal, giving mouth rinses, antibiotics, and maintenance of oral hygiene

In Vitro Assessment of Biofilm Production, Antibacterial Resistance of Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter spp. Obtained from Tonsillar Crypts of Healthy Adults.

Tonsillar crypts can be considered a reservoir for a variety of bacterial species. Some bacterial species can be considered part of the normal oropharyngeal microbiota. The roles of other pathogens, for example, the so-called non-oral and respiratory pathogens Staphylococcus aureus, Klebsiella, Pseudomonas, and Acinetobacter spp., which have strong virulence factors, biofilm production capacity, and the ability to initiate infectious diseases, are unclear. The purpose of this study was to detect the presence of S. aureus, K. pneumoniae, P. aeruginosa, and Acinetobacter spp. within the tonsillar crypts of healthy individuals, and to analyze the pathogens' biofilm production and antibacterial resistances. Only common oropharyngeal microbiota were cultivated from 37 participant samples (40.7%). The most commonly isolated pathogenic bacterium was S. aureus, which was isolated in 41 (45%) participant samples. K. pneumoniae was isolated in seven (7.7%) samples, Acinetobacter spp. were isolated in five (5.5%) samples, and P. aeruginosa was isolated in two (2.2%) samples. Biofilm producers predominated among the pathogenic bacteria; 51 strains were biofilm producers, and among them, 31 strains were moderate or strong biofilm producers. The tested S. aureus, K. pneumoniae, P. aeruginosa, and Acinetobacter spp. strains were sensitive to commonly used antibiotics (amoxicillin-clavulanic acid, clindamycin, or ciprofloxacin). One of the isolated S. aureus strains was MRSA. Biofilm is a commonly observed feature that seems to be a naturally existing form of pathogenic bacteria colonizing human tissue. S. aureus, K. pneumoniae, P. aeruginosa, and Acinetobacter spp. occasionally occur in the tonsillar crypts of healthy individuals, and, therefore, it is most likely that S. aureus, K. pneumoniae, P. aeruginosa, and Acinetobacter spp. in opportunistic tonsillar infections originate from the tonsillar crypt microbiota.

Determination of the frequency of influenza-A and B antigens in swab samples in differentiating the diagnosis of influenza infection from other causes of upper respiratory tract infection

Aim: The present study aimed to determine the frequency of influenza-A and B antigens in swab samples and to examine their potential changes at the time of initial diagnosis in differentiating the diagnosis of influenza infection from other causes of upper respiratory tract infection by physical examination and vital clinical signs in the emergency room.Material and Method: This retrospective cross-sectional descriptive research analyzed 113 patients with Influenza-A (n:8) and B (n:15) over the age of 18 who applied to the emergency department in the last three years, were diagnosed with acute upper respiratory tract and underwent nasopharyngeal swab sampling were included in the study. The data of the patients were accessed digitally from the University hospital database.Results: The headache score was higher, while there was no difference between vital clinical signs and those with positive or negative swab tests (p&amp;gt;0.05). White blood cells in blood count parameters were lower in the Influenza test-positive group (p&amp;lt;0.0001), platelet distribution width (p=0.006), and monocyte counts (p=0.008) were significantly higher in Influenza positive patients than negative ones. The influenza swab test was not positive in any patient with tonsillar crypt (p&amp;gt;0.05).Conclusion: Influenza infections should be examined in detail in terms of costs to both public health and social security institutions, considering the burdens of diagnosis and treatment.

Ultrastructure of the palatine tonsils of the donkey (Equus asinus): New insights by light, scanning, and transmission electron microscopy.

The study aimed to explore the ultrastructure of the donkeys' palatine tonsils. Palatine tonsils of five male donkeys (5 years old) were investigated macroscopically and microscopically. The tonsils appeared as a dome shape with slight elevation and a circular opening on the surface of the oropharynx. The central tonsillar crypt appeared on the medial side of the palate-pharyngeal folds and the floor of the oropharynx. The external surface of the palatine tonsil had different sizes of mucosal folds, some grooves directed to drainage at the tonsillar opening, and the tonsil crypt opening was a crescentic or irregular oval shape. The outer surface was covered by stratified squamous epithelium and modified to be reticular epithelium invaded by lymphocytes in the crypt called lympho-epithelium. The tonsil crypt had aggregated lymphoid nodules, and the cryptal epithelium has surrounded by diffused lymphocytes and hassles corpuscles-like structures. The lymphocytes infiltrated into different layers of the cryptal epithelium and transformed into reticular or lympho-epithelium. The organized lymphoid nodules were primary and secondary, and the secondary ones had a light germinal center. The interfollicular area had many high endothelial venules and blood capillaries. The endothelial venules were lined by simple cuboidal epithelium and had lymphocytes. The blood capillaries had red blood cells and neutrophils. The tonsil was surrounded incompletely by a connective tissue capsule with mucous glands under that capsule. In conclusion, the epithelial lymphocyte infiltration, crypt epithelium, lymphoid nodules, and intra-follicular area of the donkey's palatine tonsils indicate the humoral and cell-mediated immunological process.

Environmental and maternal factors shaping tonsillar microbiota development in piglets.

BackgroundThe palatine tonsils are part of the mucosal immune system and stimulate immune responses through M cell uptake sampling of antigens and bacteria in the tonsillar crypts. Little is known about the development of the tonsillar microbiota and the factors determining the establishment and proliferation of disease-associated bacteria such as Streptococcus suis. In this study, we assessed tonsillar microbiota development in piglets during the first 5 weeks of life and identified the relative importance of maternal and environmental farm parameters influencing the tonsillar microbiota at different ages. Additionally, we studied the effect sow vaccination with a bacterin against S. suis on microbiota development and S. suis colonisation in their offspring.ResultsAmplicon sequencing of the 16S rRNA gene V3-V4 region revealed that a diverse tonsillar microbiota is established shortly after birth, which then gradually changes during the first 5 weeks of life without a large impact of weaning on composition or diversity. We found a strong litter effect, with siblings sharing a more similar microbiota compared to non-sibling piglets. Co-housing in rooms, within which litters were housed in separate pens, also had a large impact on microbiota composition. Sow parity and prepartum S. suis bacterin vaccination of sows had weaker but significant associations with microbiota composition, impacting on the abundance of Streptococcus species before and after weaning. Sex and birthweight had limited impact on the tonsillar microbiota, and none of the measured factors had consistent associations with microbiota diversity.ConclusionsThe piglet tonsillar microbiota is established shortly after birth. While microbiota development is associated with both environmental and maternal parameters, weaning has limited impact on microbiota composition. Intramuscular vaccination of sows pre-partum had a significant effect on the tonsillar microbiota composition of their piglets. These findings provide new insights into the mechanisms shaping the tonsillar microbiota. Supplementary InformationThe online version contains supplementary material available at 10.1186/s12866-022-02625-8.

Analysis of Microorganism Colonization, Biofilm Production, and Antibacterial Susceptibility in Recurrent Tonsillitis and Peritonsillar Abscess Patients.

Background: Despite the widespread use of antibiotics to treat infected tonsils, episodes of tonsillitis tend to recur and turn into recurrent tonsillitis (RT) or are complicated by peritonsillar abscesses (PTAs). The treatment of RT and PTAs remains surgical, and tonsillectomies are still relevant. Materials and methods: In a prospective, controlled study, we analyzed the bacteria of the tonsillar crypts of 99 patients with RT and 29 patients with a PTA. We performed the biofilm formation and antibacterial susceptibility testing of strains isolated from study patients. We compared the results obtained between patient groups with the aim to identify any differences that may contribute to ongoing symptoms of RT or that may play a role in developing PTAs. Results: The greatest diversity of microorganisms was found in patients with RT. Gram-positive bacteria were predominant in both groups. Candida species were predominant in patients with a PTA (48.3% of cases). Irrespective of patient group, the most commonly isolated pathogenic bacterium was S. aureus (in 33.3% of RT cases and in 24.14% of PTA cases). The most prevalent Gram-negative bacterium was K. pneumoniae (in 10.1% of RT cases and in 13.4% of PTA cases). At least one biofilm-producing strain was found in 37.4% of RT cases and in 27.6% of PTA cases. Moderate or strong biofilm producers were detected in 16 out of 37 cases of RT and in 2 out of 8 PTA cases. There was a statistically significant association found between the presence of Gram-positive bacteria and a biofilm-formation phenotype in the RT group and PTA group (Pearson χ2 test, p < 0.001). S. aureus and K. pneumoniae strains were sensitive to commonly used antibiotics. One S. aureus isolate was identified as MRSA. Conclusions: S. aureus is the most common pathogen isolated from patients with RT, and Candida spp. are the most common pathogens isolated from patients with a PTA. S. aureus isolates are susceptible to most antibiotics. Patients with RT more commonly have biofilm-producing strains, but patients with a PTA more commonly have biofilm non-producer strains. K. pneumoniae does not play a major role in biofilm production.

A GIANT TONSILLOLITH IN A 13-YEAR-OLD PATIENT

Tonsillar stones or tonsilloliths are polymicrobial biofilms formed in the crypts of palatine tonsils, which become calcified by mineral deposition, especially of calcium salts. Large calcifications can cause odynophagia, dysphagia, and otalgia and are rare in young patients. A 13-year-old male patient was referred by the orthodontist for investigation of an extensive radiopaque area in the region of the left ascending ramus of the mandible observed on panoramic radiograph. The patient was asymptomatic and did not report any other disease. On clinical examination, no alterations in the parotideomasseteric region or oral lesions were observed. Blood tests and ultrasonography of the parotideomasseteric and submandibular regions and fan beam tomography were requested. Ultrasonography and blood tests were unremarkable, whereas tomography revealed a large, calcified mass in the soft tissues of the parapharyngeal space, measuring 1.9 × 2.5 cm and compatible with a tonsillolith. The patient was then referred for tonsillectomy.

An unusual case of lymphoepithelial cyst of palatine tonsil

Amongst the various cystic lesions of oral cavity, Lymphoepithelial cyst (LEC) is a rare cystic lesion that presents as an asymptomatic submucosal mass and is usually discovered during routine oral examinations. Most common site of occurence is the floor of the mouth but tonsillar involvement seems to be very rare. Pathogenesis involves the excessive accumulation of desquamated epithelial lining in the tonsillar crypt. This results in a dilated obstructed crypt of the palatine tonsil region which presents as a cystic lesion. Here we are reporting a case of 17 year old female with lymphoepithelial cyst of tonsil.

A Proposal to Perform High Contrast Imaging of Human Palatine Tonsil with Cross Polarized Optical Coherence Tomography

The palatine tonsils provide the first line of immune defense against foreign pathogens inhaled or ingested. However, a disruption in the epithelial layer within the tonsil crypts can lead to recurrent acute tonsillitis (RAT). Current imaging techniques suffer from poor resolution and contrast and do not allow a classification of the severity of RAT. We have developed a cross-polarized optical coherence tomography system. The system can detect a change in the polarization of the light after the light-tissue interaction. We demonstrate improved resolution and contrast in tonsil imaging with the developed method. Intensity, as well as retardance images of the excised tonsil tissue, were acquired. Features such as crypt epithelium, lymphoid follicles, and dense connective tissue were observed with improved contrast. Cross polarized optical coherence tomography can be a valuable tool in the clinic to evaluate palatine tonsils as it would allow visualizing common tonsil features without the need for any external contrast agent.

Evaluation of Staphylococcus aureus Colonization in Adult Patients Undergoing Tonsillectomy for Recurrent Tonsillitis.

Background and objectives: Staphylococcus aureus (S. aureus) is often recovered from the pharynx. However, the role of this pathogen in the etiology of tonsillar inflammation is still unclear and complicated due to frequent carriage of S. aureus. The aim of the study was to evaluate the frequency and the clinical importance of S. aureus colonization and biofilm production ability in patients with recurrent tonsillitis (RT) using patient samples from tonsillar crypts during tonsillectomy, and from the throat, nasal cavity, and armpits after tonsillectomy. Materials and Methods: A case series study was carried out at a tertiary referral center among 16 patients diagnosed with RT who were undergoing tonsillectomy. Samples from tonsillar crypts were obtained during tonsillectomy, and samples from the throat, nasal cavity, and armpit were obtained a year after surgery. An evaluation of S. aureus incidence, biofilm formation, and antibacterial susceptibility was performed. Results: During tonsillectomy, 16 strains of S. aureus were isolated from 16 patients, while 15/16 S. aureus strains were biofilm producers. A year after tonsillectomy, 8 S. aureus strains were isolated from 6 out of 16 patients, while 6/8 S. aureus strains were biofilm producers. After tonsillectomy, 3 patients showed S. aureus in throat culture. Conclusions: In 10/16 cases S. aureus was the causative agent of RT, in 4/16 cases patients had a predisposition to colonization of S. aureus, and in 2/16 cases S. aureus was a part of the patients` oral microbiome. Tonsillectomy results in less frequent isolation of S. aureus strains.

A giant tonsillolith: An unusual cause for longstanding foreign body sensation in throat

Foreign body sensation in throat is a common complaint by patients at the outpatient department in routine clinical practice. Long-standing tonsillolith is an uncommon cause for foreign body sensation in throat. Tonsilloliths are also called as tonsillar calculi or tonsillar stones or throat stone which form in the crypts of the faucial or palatine tonsils. They are usually small in size. The exact etiopathogenesis for the formation of tonsillolith is not known. It may protrude out of the tonsillar crypt and provide foreign body sensation in throat and usually not harmful to the body. It is a common cause for bad breath or halitosis in adult patients with tonsillolith. Finding giant tonsilloliths is rare in clinical practice. Here, we report a case of a giant tonsillolith in left palatine tonsil which was associated with long standing foreign body sensation in throat. Here, we report a 62-year-old man presenting for giant tonsilloliths with complaint of long-standing foreign body sensation in throat.

Tonsillolith – A rare cause of halitosis and odynophagia in a 9-year-old girl

Tonsil stones, also known as tonsilloliths or tonsiliths, areusually tiny white or yellowish mineralized structurespacked with organic debris and bacteria that develop inthe enlarged palatine tonsillar crypt. Tiny tonsillitis is commonlydetected in diagnostic imaging such as computed tomography(CT) and less so in panoramic radiography, with the prevalenceincreasing with age. Giant tonsilloliths are rare and most reportedcases have been in adults, with only a few cases reported in thepediatric population. In this report, we described a 9-year-old girlwho had suffered from halitosis for 6 months and odynophagiawith oropharyngeal foreign body sensation for 2 weeks and waslater diagnosed with a tonsil stone.

Recent advancements in our understanding of equid gammaherpesvirus infections.

Equid gammaherpesviruses are ubiquitous and widespread in the equine population. Despite their frequent detection, their contribution to immune system modulation and the pathogenesis of several diseases remains unclear. Genetic variability and the combination of equid gammaherpesvirus strains a horse is infected with might be clinically significant. Initial gammaherpesvirus infection occurs in foals peripartum with latency then established in peripheral blood mononuclear cells. A novel EHV-5 study suggests that following inhalation equid gammaherpesviruses might obtain direct access to T and B lymphocytes via the tonsillar crypts to establish latency. EHV-5 is associated with equine multinodular pulmonary fibrosis, however, unlike with EHV-2 there is currently minimal evidence for its role in milder cases of respiratory disease and poor performance. Transmission is presumed to be via the upper respiratory tract with periodic reactivation of the latent virus in adult horses. Stress of transport has been identified as a risk factor for reactivation and shedding of equine gammaherpesviruses. There is currently a lack of evidence for the effectiveness of antiviral drugs in the treatment of equine gammaherpesvirus infections.

S. aureus and K. pneumoniae on the Surface and within Core of Tonsils in Adults with Recurrent Tonsillitis.

Background and Objectives: Recurrent tonsillitis is an infection of the palatine tonsils. Samples for microbiological testing are usually obtained from the inflamed surface of the tonsils. Colonizing the surface bacteria does not always correlate with pathogens causing recurrent tonsillitis and there is no consensus or this in research studies. The aim of the study was to compare whether Staphylococcus aureus (S. aureus) and Klebsiella pneumoniae (K. pneumoniae) differ when isolated from the tonsillar surface or tonsillar crypts in patients with recurrent tonsillitis. Materials and Methods: a case series study was conducted at a tertiary referral center among 25 patients diagnosed with recurrent tonsillitis. An evaluation of S. aureus and K. pneumoniae incidence, biofilm formation and antibacterial susceptibility was performed. Results: There was a statistically significant association between surface and punch biopsy samples for S. aureus (Fisher’s Exact test p = 0.004) and K. pneumoniae (Fisher’s Exact test p < 0.001). A McNemar test did not reveal a statistically significant association. Although the antibacterial resistance profile was not broad, five out of nine S. aureus isolates were biofilm producers and four out of five K. pneumoniae isolates were biofilm producers. Conclusions: Surface and core cultures of tonsils are comparable with a differing incidence between the surface and the punch biopsy cultures for S. aureus and K. pneumoniae. A larger quantity of bacteria exist in surface samples suggesting that a biopsy sample may be less challenging in evaluating recurrent tonsillitis. We recommend that antibacterial susceptibility results are considered alongside the biofilm-forming potential of isolated bacteria.

Mycoplasma bovis May Travel Along the Eustachian Tube to Cause Meningitis in Japanese Black Cattle

Mycoplasma bovis (M. bovis) is a common inhabitant of the upper and lower respiratory tracts of cattle and is considered to be the main aetiological agent of otitis media in calves. The eustachian tube appears to be the most common portal for pathogens to enter the middle ear. We investigated the transmission route of M. bovis causing otitis media that progressed to meningitis or meningoencephalitis in Japanese Black cattle. M. bovis was detected in 10 cases by a loop-mediated isothermal amplification method or by immunohistochemistry. One case of caseonecrotic granulomatous meningoencephalitis, one case of caseonecrotic granulomatous meningitis, one case of suppurative meningoencephalitis, eight cases of eustachitis, nine cases of tonsillitis and six cases of suppurative bronchopneumonia were identified by histopathological examination. M. bovis antigen was detected in the eustachian tubes of eight cases. In nine cases, M. bovis was also detected in tonsillar epithelial crypts and lumina, in intraluminal inflammatory cells and in the epithelial cells of minor salivary glands located around the eustachian tubes and tonsils. The results suggest that M. bovis can infect and colonize the tonsils and enter the eustachian tubes, causing otitis media, which, in cases of chronic infection, can progress to meningitis.