Chlamydophila pneumoniae Infection Assessment in Children With Adenoid Hypertrophy Concomitant With Rhino Sinusitis

BACKGROUND: Since adenoids may act as a reservoir for bacteria, they can cause ear infection, recurrent otitis and recurrent adenotonsillitis. Therefore, adenotonsillectomy is an efficient method for reducing the number and severity of subsequent infections. OBJECTIVES: This study aimed to determine the Chlamydophila pneumonia infection by serological tests and performing PCR in the adenoid tissue, in children undergoing adenoid surgery and compare the results with normal children. PATIENTS AND METHODS: This case control study was conducted in the ENT and pediatric wards of Rasoul Akram Hospital in Tehran (2008-2011). We studied 53 patients who had undergone the adenoid surgery (adenoid hypertrophy concomitant with rhino sinusitis) and 31 other patients undergoing elective surgeries in the general surgery ward (like orthopedic surgeries, hernia, etc.) without any infection (like rhinosinusitis), as the control groups. We searched for C. pneumoniae by PCR kits (Chemicon, Germany) in resected adenoid tissues and nasopharyngeal swabs of controls (ethics restrictions in controls). We also looked for specific IgM & IgG antibodies (ELISA, Biochem Immuno Systems, Italy) and compared them between the two groups. A P value < 0.05 was considered statistically significant. RESULTS: Positive PCR results were observed in 13.5% of cases and none of the controls. The condition prevalence was higher in warm seasons (P = 0.05). No correlation was found between positive PCR results and patients' gender. IgM presence was observed in 11% (6.51) of cases and 6.5% (2.31) of controls (P = 0.7). IgG results were not positive in any of the cases (0.51), whereas positive results were seen in 13.3% of the controls (P = 0.007). IgM results showed no significant difference with PCR results (P = 0.7) but IgG results did (P = 0.05). CONCLUSIONS: The results of the study showed a positive correlation between PCR and serology (IgM) results in the case group. Recent C. pneumoniae infection was proved to exist by PCR and serology (IgM) in patients who had undergone adenoidectomy. In contrast to the controls, none of the patients in the study group showed previous immunity. Findings indicate the probable role of C. pneumoniae infection, in inducing adenoid hypertrophy in nearly 13% of cases.