Correlation between surface swab culture and tonsillar core culture in patients with recurrent tonsillitis

Objective: To determine the correlation between surface culture swab and culture of tonsillar core in patients with recurrent tonsillitis. Patients and Methods: One hundred patients booked for elective tonsillectomy were studied. There were 38 females and 62 males between the ages of 3 and 35 years. Specimens from both surface and core of tonsils were cultured. Results: Pathogens were isolated by core culture but not by the surface culture in 36 cases. In 42 cases pathogenic micro flora were identified from the core of tonsils differing from the surface bacteria. Discrepancy between surface and core culture as to the presence or absence of core pathogens was in 62 cases (62%) while it was identical in 38 cases (38%). In 20 cases (20%) pathogenic microflora was present on surface culture with normal core flora. 14 cases (14%) of the study group showed normal flora. The principal isolate from both the tonsillar surface and core were Staphylococcus aureus followed by Group A beta hemolytic streptococci, S. pneumonia, Haemophilus influenza, Escherichia coli, Pseudomonas aeruginosa and S. viridans. Conclusion: The study indicates that pharyngeal swab cultures do not reliably reflect the presence of pathogens in the tonsil core. The tonsil surface reflected mainly the normal flora of the oropharynx, whereas tonsil core showed growth of organisms like Hemophilus and Staph aureus, which were rarely reflected in the surface culture.