title: Microbiological profile of adenoid hypertrophy correlates to clinical diagnosis in children.
abstract: OBJECTIVE
  Adenoid hypertrophy is a common condition in childhood, which may be associated with recurring acute otitis media (RAOM), otitis media with effusion (OME), and obstructive sleep apnea syndrome (OSAS). These different clinical characteristics have some clinical overlap; however, they might be explained by distinct immunologic and infectious profiles and result in various histopathologic findings of adenoid specimens.
  
  
  METHODS
  A total of 59 children with adenoid hypertrophy undergoing adenoidectomy were studied. Three series of identical adenoid specimens were processed to hematoxylin-eosin (H.E.) and Gram staining and to respiratory virus specific real-time PCR, respectively.
  
  
  RESULTS
  According to the clinical characteristics, patients were recruited into three groups: RAOM (n = 25), OME (n = 19), and OSAS (n = 15). Bacterial biofilms were detected in 21 cases, while at least one of the studied respiratory viruses was detected in 52 specimens. RAOM cases were significantly associated with biofilm existence (n = 20, P < 0.001). In contrast, OME group was characterized by the absence of bacterial biofilm and by normal mucosa. Showing a statistically significant correlation, all OME cases were positive for human bocavirus (HBoV, P < 0.001).
  
  
  CONCLUSIONS
  Bacterial biofilms might contribute to the damage of respiratory epithelium and recurring acute infections resulting in RAOM. In OME cases persisting respiratory viruses, mainly HBoV, can cause subsequent lymphoid hyperplasia leading to ventilation disorders and impaired immunoreactivity of the middle ear cleft.
authors.affiliation: Department of Medical Microbiology, Medical and Health Science Center, University of Debrecen, Nagyerdei Krt. 98, Debrecen 4032, Hungary.
authors.forename: Anita
authors.initials: A
authors.lastname: Szalmás
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Papp
authors.forename: Péter
authors.initials: P
authors.lastname: Csomor
authors.forename: József
authors.initials: J
authors.lastname: Kónya
authors.forename: István
authors.initials: I
authors.lastname: Sziklai
authors.forename: Zoltán
authors.initials: Z
authors.lastname: Szekanecz
authors.forename: Tamás
authors.initials: T
authors.lastname: Karosi
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000382:microbiology / Q000473:pathology / Q000601:surgery / Q000821:virology; D018441:Biofilms; D002648:Child; D002675:Child, Preschool; D005260:Female; D056661:Human bocavirus; D006801:Humans; D006984:Hypertrophy / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000601:surgery / Q000821:virology; D008297:Male; D010322:Parvoviridae Infections / Q000175:diagnosis / Q000382:microbiology / Q000473:pathology / Q000601:surgery / Q000821:virology; D011446:Prospective Studies