Bacterial invasion of the tonsillar tissues in acute pharyngotonsillitis and in the adenoid: a preliminary study

In order to understand the immunological and inflammatory processes in which the tonsils are involved it is necessary to know the spatial relation between bacteria and the tissues. In this study four adenoids and four palatine tonsils obtained at elective surgery and four palatine tonsils obtained during à chaud surgery for quinsy were examined histologically. Acridine orange and fluorescence microscopy were used to identify bacteria in tonsillar tissue. The adenoids were also stained with haematoxillin-eosin. Bacteria were in every case seen on the surfaces and in the crypts of the tonsils and adenoids. In the tissues, however, bacteria were never seen irrespective of whether the tonsils were obtained during an acute infection or not. We conclude that bacterial invasion in tonsillar tissue is neither a prerequisite for a clinically manifest acute bacterial pharyngotonsillitis nor a common feature in tonsils clinically recognized as non-infected.