الفهرس 
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Abstract
This study included 54 children with age ranges from 2 to 14 years with chronic tonsillitis. They underwent elective tonsillectomy in the E.N.T. department of EL-Minia University hospital. The following specimens were taken from each patient; throat swab after positioning the patient under general anesthesia, core swab specimen after removal of tonsils and blood sample early post operative (within two minutes after tonsillectomy) for bacteriological examination. Pathogens were detected in 81.5% of core specimens versus 44.4% in surface swab culture. Throat swab was found to have 38.9% sensitivity, 33.3% specificity and 63.6% positive predictive value in detecting pathogens in cases of chronic tonsillitis. Staphylococcus aureus was the most commonly grown organism in the core of the tonsils and/or surface culture (42 patients out of 54(77.7%)), 4 in throat swab only 20 in tonsil core only and 18 in both throat swab and tonsil core, group A β hemolytic streptococci was isolated from 10 patients (18.5%), 2 cases yielded the organism in throat swab and 8 cases yielded the organism in the tonsil core, E.coli was detected in tonsil core of 2 patients (3.7%), and Klebsiella pneumoniae was detected in both throat swab and tonsil core of 2 patient (3.7%). Regarding antibiotic sensitivity, commonly used antibiotics yielded unsatisfactory results for isolated pathogens. The incidence of post tonsillectomy bacteraemia in the current study was 7.4% (4/54). Staph aureus was isolated from the 4 cases.
In conclusion, there is discrepancy between tonsillar surface and tonsillar core culture results in cases of chronic tonsillitis. Staph aureus was the commonest isolated organism in throat swab or core culture. The problem of bacterial resistance to commonly used antibiotics is apparent but further studies on larger scales are needed to determine the magnitude of the problem. Post-tonsillectomy bacteraemia occurs in low percent of patients.