THE EFFECT OF TONSILLECTOMY ON THE INCIDENCE OF STREPTOCOCCAL RESPIRATORY DISEASE AND ITS COMPLICATIONS

Abstract

A population of military men with acute streptococcal respiratory infections (diagnosis established by clinical, bacteriologic and serologic studies) was investigated. Evidence is presented indicating that individuals who have had a tonsillectomy are neither more nor less susceptible to acute streptococcal infections of the respiratory tract. Once individuals acquire a streptococcal infection, the clinical course of the acute illness is not modified appreciably by the presence or absence of the tonsils. However, if antibiotic therapy is withheld, suppurative complications occur less frequently in those patients who have had their tonsils removed. Tonsillectomy did not alter significantly the attack rate of acute rheumatic fever as a sequel of streptococcal infections, nor did it reduce significantly the development of valvular heart disease in patients with acute rheumatic fever. Moreover, it appears that streptococcal infections are less readily recognized in tonsillectomized patients and, therefore, are more likely to escape treatment appropriate for the prevention of rheumatic fever.