Stjernquist-Desatnik A, Prellner K, Christensen P
Department of Oto-Rhino-Laryngology, University Hospital, Lund, Sweden.
Acta Otolaryngol. 1987 Sep-Oct;104(3-4):351-9. doi: 10.3109/00016488709107339.
In 82 patients with acute tonsillitis studied, beta-hemolytic group A streptococci were isolated from 30 (37%), and group C or G streptococci from 12 (15%). In the 40 patients with non-streptococcal tonsillitis there was a significantly higher isolation rate of pneumococci, H. influenzae and/or B. catarrhalis, as compared with those with beta-hemolytic streptococci. Patients were classified regarding clinical status according to standardized criteria as severe, moderate, or mild. The patients with group A streptococcal tonsillitis were significantly more often classified clinically as 'severe' and had significantly shorter duration of symptoms before seeking medical care, as compared with those with non-streptococcal tonsillitis. Significant increases in white blood cell count and in anti-DNase B were found in the patients with group A streptococcal tonsillitis, whereas their antistreptolysin O levels did not increase significantly. C-reactive protein concentrations were consistently higher in the patients with group A streptococcal tonsillitis. No evidence of polyclonal beta-lymphocyte stimulation was found when measuring antibodies against pneumococci and group B streptococci. The findings show clinical and simple laboratory tests to be useful aids in distinguishing group A streptococcal tonsillitis from non-streptococcal tonsillitis, and that other bacteria may be involved in non-streptococcal tonsillitis.
在对82例急性扁桃体炎患者的研究中，从30例（37%）患者中分离出A组β溶血性链球菌，从12例（15%）患者中分离出C组或G组链球菌。在40例非链球菌性扁桃体炎患者中，肺炎球菌、流感嗜血杆菌和/或卡他莫拉菌的分离率显著高于β溶血性链球菌感染患者。根据标准化标准，将患者的临床状态分为重度、中度或轻度。与非链球菌性扁桃体炎患者相比，A组链球菌性扁桃体炎患者临床上被分类为“重度”的情况更为常见，且在就医前症状持续时间显著更短。A组链球菌性扁桃体炎患者的白细胞计数和抗DNase B显著升高，而其抗链球菌溶血素O水平没有显著升高。A组链球菌性扁桃体炎患者的C反应蛋白浓度始终较高。在检测针对肺炎球菌和B组链球菌的抗体时，未发现多克隆β淋巴细胞刺激的证据。研究结果表明，临床和简单的实验室检查有助于区分A组链球菌性扁桃体炎和非链球菌性扁桃体炎，且其他细菌可能与非链球菌性扁桃体炎有关。
