Microbiology of Severe Acute Tonsillitis, Peritonsillar Cellulitis, and Infectious Mononucleosis

Study Overview
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Brief Summary
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Prospective, observational study of the microbiology of patients referred to a tertiary care center with severe acute tonsillitis, peritonsillar cellulitis, or infectious mononucleosis.

Detailed Description
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Patients referred to tertiary care centers with acute throat infections are most often treated with antibiotics. However, very little is know concerning the prevalent pathogens in patients with acute throat infections without abscess formation. Evidence suggests that Fusobacterium necrophorum plays an important role in complications of acute tonsillitis (e.g. peritonsillar abscess), but also uncomplicated acute tonsillitis. This study aims to explore the throat microbiology of patients with severe acute tonsillitis, peritonsillar cellulitis, or infectious mononucleosis with a special attention to a possible role of Fusobacterium necrophorum.

Official Title
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Mikrobiologi Ved svær Akut Tonsillit, peritonsillær Phlegmone og infektiøs Mononukleose

Conditions
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Acute Tonsillitis, Peritonsillar Cellulitis, Infectious Mononucleosis

Intervention / Treatment
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* Other: Throat swabbing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients referred to our tertiary care center with acute tonsillitis with or without signs of peritonsillar cellulitis and with or without infectious mononucleosis. Center Score 3 or 4. Exclusion Criteria: Abscess formation. Previous tonsillectomy.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Acute tonsillitis<br>Patients referred to the tertiary care center with severe acute tonsillitis but without peritonsillar cellulitis, infectious mononucleosis, or abscess formation. | Other: Throat swabbing<br> <br> * Other names: Blood sample;|
| Peritonsillar cellulitis<br>Patients referred to the tertiary care center with severe acute tonsillitis and peritonsillar cellulitis but without abscess formation. | Other: Throat swabbing<br> <br> * Other names: Blood sample;|
| Infectious mononucleosis<br>Patients referred to the tertiary care center with acute tonsillitis and biochemical or serological signs of infectious mononucleosis but without abscess formation. | Other: Throat swabbing<br> <br> * Other names: Blood sample;|
| Controls<br>Patients treated for conditions not related to the throat and without signs or symptoms of recent throat disease. | Other: Throat swabbing<br> <br> * Other names: Blood sample;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of Fusobacterium necrophorum in throat swab cultures |  | At acute consultation (day 0) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of participants with recurrent throat infections (questionnaire) |  | Six months after acute consultation | 
| Number of participants without eradication of throat pathogens (throat cultures) | Throat pathogens: Fusobacterium necrophorum, Beta-hemolytical streptococci, A. hemolyticum | 14-28 days after acute consultation | 
| Number of participants with complications of severe acute tonsillitis, peritonsillar cellulitis, and infectious mononucleosis | Complications: admission, abscess Development, change of antibiotic treatment | 14-28 days after acute consultation | 
| Prevalence of anti-Fusobacterium necrophorum antibody Development (two-fold or higher increase in antibody level) (blood samples) | Comparison of the prevalence of antibody Development (two-fold or higher increase in antibody level) between patients with recovery of Fusobacterium necrophorum in throat swabs versus patients without recovery of Fusobacterium necrophorum in throat swabs | In acute and convalescent sera (day 0 and 14-28) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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fusobacterium necrophorum, acute tonsillitis, peritonsillar cellulitis, infectious mononucleosis, microbiology, antibody development