Searching the M. Pneumoniae; serology &PCR in children with adenoid hypertrophy and rhino sinusitis: A case control study, Tehran, Iran
Background and Objectives: Chronic infection in childhood is a leading cause of adeno-tonsillectomy. The aim of this study was to determine the role of M. pneumoniae in children with rhino sinusitis and adenoid hypertrophy.
Method and material: This case /control study was carried out in pediatric and ENT wards of Rasul Hospital, Tehran (2007-2009) upon 40 cases with with adenoid surgery and 32 controls. M.Pneumoniae -DNA (PCR) searched in 40 resected adenoid tissue and 31 nasopharyngeal swabs in controls, IgM & IgG antibodies (ELISA) compared between 2 groups , P<0.05 had significant value .
Results: Positive PCR observed in 35% of cases and none of controls,positive-IgG:20% of cases (6.4% of controls ,P= 0.71), higher in older cases (6 vs. 4 years,p<0.05). Positive –IgM seen in 10% of cases ( 9.7% of controls ,P= 0.74); without any differences for age (6.2/ 5.3 years, p=0.1) .Positive PCR was not related to positive IgG (p=0.014), but related to positive IgM (p= 0.1)
Conclusion: M. pneumoniae infection proven serologically (IgM&IgG) in10% and 20% of cases.Adding it to positive PCR in adenoid tissue of cases (30%) indicates the prominent role for M. Pneumoniae in adenoid hypertrophy. We conclude that children in Iran infected with M. pneumoniae and obtained immunity between 6-8 years .Adenoid tissue might acts as a reservoir for M. pneumoniae and causing rhino sinusitis concomitant with adenoid hypertrophy in infected children. Theoretically, use of suitable antibiotics to eradicate the M.Pneumoniae, before adenoid surgery (with rhino sinusitis or chronic ear infection) might be helpful but needs future RCT studies.