The role of tonsillar actinomycosis in adult patients

Abstract

Background: Tonsillectomy is one of the most commonly performed surgical procedures. There are many indications for the surgery, and these vary for children and adults. A common finding on tonsillectomy histology is the presence of the bacteria actinomycosis. The objective of the study was to establish the incidence of actinomycosis in the tonsils of adults undergoing tonsillectomy and to evaluate its role in tonsillar disease. Methods: This study is a retrospective record review, for the period 1 July 2005 to 30 June 2015. It was conducted in the clinical units of the University of the Witwatersrand’s Department of Otorhinolaryngology (ENT). The study population included all patients older than 18 years of age, who had a tonsillectomy performed with subsequent histological analysis. There were 638 specimen reports reviewed, comprising 319 patients. Results: In the study sample the patient ages ranged from 18 to 77 years old, with a mean age of 35 years and a standard deviation of 12 years. The frequency of actinomycosis was 11.6% (74 specimens) in our study population. Ninety-eight percent of patients with actinomycosis had reactive tonsillar hypertrophy as compared to the control group (No Actinomycoses) in whom 77% of patients had tonsillar hypertrophy. This difference was significant (P=0.002). Conclusions: Based on our study it can be said that when actinomycosis is present, there is almost always lymphoid hyperplasia as well.