Razi Journal of Medical Sciences

    Background & Aim: Recurrent or chronic adenotonsillar infections mainly affect children. The prevalence of potential respiratory pathogens on the adenoid and tonsillar surfaces of children with moderate symptoms of recurrent tonsillopharyngitis and/or adeno tonsillar hypertrophy differs only slightly from that in children without symptoms of adenotonsillar disease. Chlamydia pneumoniae is a common respiratory pathogen which is often found in children. Little is known about the true colonization rate and the localization of the bacteria in the respiratory tract. The findings suggest that Chlamydia pneumoniae is a common pathogen in the adenoids of children undergoing adenoidectomy. The aim was to determine Chlamydia pneumoniae infection in adenoid tissue of adenoidectomized children by PCR and specific antibody in serum. Patients and Methods: In a descriptive cross sectional study during 2005-2006 in ENT department of Rasool Akram hospital, detection of Chlamydia DNA by PCR was performed on 44 adenoid tissue of adenoidectomized children. 168 ELISA tests (IgG&IgM for each sample) were performed. Samples were collected from 53 patients(63.1%) and 31 normal(36.9%) children. The data gathered were analyzed by SPSS 10.5 software. Results: Age of children was between 3-14 years, range 11yr mean 7.95(SD=1.98years). Also there were 54.8% males and 45.2% females. Season of adenoidectomy was: 24% spring 18% summer 36% autumn and 22% in winter. Chlamydia-DNA by PCR was positive in 7(15.9%) of adenoid tissues. Positivity of PCR did not differ with age or sex. Acute chlamydial infection was seen in 3.7% previous immunity was seen in 12.3% of all children. By serology method in 51 patients, acute chlamydia infection was detected in 1(2%) and previous immunity in 6(11.8%). Acute and previous infections did not differ significantly between case and control group. Conclusion: The results suggest that Chlamydia pneumoniae(C. Pneumoniae)is a common finding in the adenoids of children undergoing adenoidectomy. The adenoid tissue, may act as a reservoir for bacteria causing sinusitis, lung and chronic ear infection. Whether or not C. pneumoniae plays a pathogenic role in this group of patients, could not be determined from the data obtained in this investigation. In cases of resistant adenoiditis to usual drugs, we recommend the use of specific antibiotics for Chlamydia(appropriate for age) including erythromycin, tetracycline or other new macrolids (e.g azithromycin, clarythromycin) before surgery.