Prevalence of tonsillar Actinomyces in children undergoing tonsillectomy for sleep disordered breathing compared with recurrent tonsillitis

Objective: To determine the prevalence of tonsillar actinomycosis in pediatric tonsillectomies performed for sleep disordered breathing (SDB) compared with recurrent infective tonsillitis. Methods: All tonsillectomy specimens performed in a pediatric otolaryngology practice over a 10-year period were sent to the same pathology laboratory for histological analysis for the prevalence of Actinomyces. A database of 1213 children was generated and analyzed to determine any significant differences in Actinomyces carriage between children with a primary diagnosis of sleep disordered breathing, compared with recurrent tonsillitis. Statistical analysis was performed using a 2 way contingency table, and significance analyzed via chi-squared and Fisher's exact test. Results: Four hundred and sixty five children aged less than 16 underwent tonsillectomy for recurrent tonsillitis and 748 for SDB. Actinomyces were identified in 68 of the group with recurrent tonsillitis (14.6%) and in 153 of the group with SDB (20.5%). This difference was statistically significant with p = 0.009 on two-tail Fisher's exact test. Conclusion: There was a statistically significant higher rate of Actinomyces colonization in children undergoing tonsillectomies for SDB compared to recurrent tonsillitis