The tonsils of 97 children undergoing tonsillectomy were studied to determine the correlation between surface culture swab and culture of tonsillar core. In many cases, pathogenic organisms were found in the tonsil core, despite the fact that surface cultures revealed only normal respiratory flora. The tonsil core cultures showed a high incidence of Hemophilus influenzae and Staphylococcus aureus, which was rarely reflected on surface culture. The study indicates that pharyngeal swab cultures do not reliably reflect the presence of pathogens in the tonsil core. The value of parameters such as history of recurrent bouts of tonsillitis and presence of erythema or cryptic debris on physical examination for predicting the differential bacteriology of the tonsil is studied. The implications for treatment of children with adenotonsillar hypertrophy are discussed.

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with interest the study by Goldstein et al (1998;119:444-54) regarding the intratemporal complications of otitis media at the Children's Hospital of Pittsburgh. In Table 1, the demographics of the patients in their study were presented, including the racial breakdown. Without knowledge of the racial breakdown of the general population in the Pittsburgh area, however, the numbers of each race presenting with a complication are meaningless. I would suggest that authors provide general population statistics when offering absolute numbers regarding study demographics.

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