Lilja M, Räisänen S, Stenfors L E
Department of Otolaryngology, University of Tromsø, Norway.
J Laryngol Otol. 1998 Jul;112(7):634-8. doi: 10.1017/s0022215100141301.
Fifty-five samples of pus were collected from 51 acute, non-perforated, two spontaneously ruptured and two recurrent peritonsillar abscesses (35 males and 18 females; median age 18 years) and analysed regarding (i) aerobic and anaerobic bacteria (standard culturing), (ii) morphology of bacteria and inflammatory cells (direct microscopy of acridine orange-stained material), and (iii) the percentage of bacteria coated with immunoglobulins IgG, secretory IgA (SIgA) and IgM and complement cleavage product C3b (immunofluorescence assay). Seventy-one per cent of the abscesses harboured a mixed bacterial flora of various aerobes and anaerobes. In none of the cases with a single bacterial species (27 per cent) could immunoglobulin- or complement-coated bacteria be found. In abscesses with a mixed flora, 18 per cent harboured IgG-coated, 15 per cent SIgA-coated, five per cent IgM-coated and five per cent C3b-coated bacteria, respectively. All pus samples contained inflammatory cells in abundance but they were mostly deformed and only occasionally could intracellular bacteria be recognized. Insufficient immunoglobulin-coating of bacteria might be an important aetiopathogenic factor in the development of a peritonsillar abscess. Bactericide in the abscesses is accomplished chiefly by protective mechanisms not dependent on antigen recognition by antibodies.
从51例急性、非穿孔性、2例自发性破裂和2例复发性扁桃体周脓肿患者（35例男性和18例女性；中位年龄18岁）中采集了55份脓液样本，并对其进行了以下分析：（i）需氧菌和厌氧菌（标准培养）；（ii）细菌和炎性细胞的形态（吖啶橙染色材料的直接显微镜检查）；（iii）被免疫球蛋白IgG、分泌型IgA（SIgA）、IgM和补体裂解产物C3b包被的细菌百分比（免疫荧光测定）。71%的脓肿含有多种需氧菌和厌氧菌的混合菌群。在单一细菌种类的病例（27%）中，均未发现有免疫球蛋白或补体包被的细菌。在混合菌群的脓肿中，分别有18%含有IgG包被的细菌、15%含有SIgA包被的细菌、5%含有IgM包被的细菌和5%含有C3b包被的细菌。所有脓液样本中均含有大量炎性细胞，但大多已变形，仅偶尔能识别出细胞内细菌。细菌免疫球蛋白包被不足可能是扁桃体周脓肿发生的一个重要病因学因素。脓肿中的杀菌作用主要通过不依赖抗体抗原识别的保护机制来完成。
