Tonsillectomized Patients Research Articles

Scarlet fever and Diphtheria in Tonsillectomized Children.

SummaryIn the Stockholm Hospital for Infectious Diseases the scarlet fever and diphtheria cases over a six year period have been studied with reference to the course of these diseases in tonsillectomized patients. 104 cases of scarlet fever and 71 cases of diphtheria all of whom had had previous tonsillectomies were compared with a suitable series of controls consisting of 3 times as many patients. The results in regard to the scarlet fever cases are as follows:1. There probably exists no difference in regard to the severity of onset as estimated by the angina and eruption in tonsillectomized and non‐tonsillectomized individuals.2. The number of cases with complications as well as the different complications occur on the whole in the same frequency in the two groups (No statistically determinable difference).3. Tonsillectomized patients cause just as many infections as do the non‐tonsillectomized after they return to their homes, thus indicating that the contagiousness at the later stage of the disease is not dependent on the presence or absence of the tonsils.4. Hemolytic streptococci can be demonstrated later in the convalescent period in non‐tonsillectomized than in tonsillectomized individuals.The results in regard to the diphtheria cases are as follows:1. Diphtheria of the pharynx is much more frequent among diphtheria patients with tonsils than among those who have had a tonsillectomy. Nasal diphtheria is common among the latter.2. Malignant diphtheria occurs considerably oftener among non‐tonsillectomized than among tonsillectomized patients.3. The frequency of complications is less among tonsillectomized than among non‐tonsillectomized patients.

EFFECT OF TONSILLECTOMY AND ADENOIDECTOMY ON THE REACTION TO THE SCHICK TEST (DIPHTHERIA IMMUNITY)

It is generally admitted that diphtheria is less common in children who have had their tonsils and adenoids removed than in those who have not undergone such an operation. Several explanations have been offered: (1) that removal of the tonsils and adenoids influences the humoral immunity against diphtheria; (2) that it eliminates the portal of entry of the diphtheria bacilli, and (3) that the tonsils offer a fertile soil for the growth of diphtheria bacilli. Schick and Topper¹performed Schick tests on children before tonsillectomy and adenoidectomy and again six months after operation. Their results were striking and would indicate that the decrease in diphtheria in tonsillectomized patients is due to the acquisition of humoral immunity, if the Schick test is used as a measure of immunity against diphtheria. They reported observations on 100 children between 1 and 12 years of age who had a positive Schick reaction before