Role of C-Reactive Protein in Diagnosis of Acute Tonsillitis : A Study Done at Western Regional Hospital, Nepal

Abstract

Introduction: Acute tonsillitis, defined as an inflammation of the tonsils is a part of the spectrum of sore throat. It is a common diagnosis of patients in Ear, Nose, Throat out-patient department with a sore throat. It equally affects both gender and all age
groups. There has been an alarming increase in the use of antibiotics in acute tonsillitis. Thus our study aims to establish the rational use of antibiotics in acute tonsillitis by differentiating between bacterial from tonsillitis due to other etiologies. Thus, we have used the C-Reactive protein as a tool to support the diagnosis of bacterial tonsillitis.

Materials and Methods: This is an observational study conducted from January 2018 to January 2019 in the Department of ENT, Pokhara Academy of Health Sciences. The objective of this study is to establish the role of C-reactive protein for the diagnosis of acute bacterial tonsillitis. Patients of all age groups presented with sore throat and fever and diagnosed with acute tonsillitis were enrolled
in the study . Complete blood count with throat swab culture sensitivity and C- reactive protein were sent and reports were studied. SPSS was used to analyse the data. Association between variables was examined using independent sample T-test, Chi square test and binary logistic regression OR with 95% CI was reported.

Results: There were 35 patients ie. 37.2% labeled as a bacterial group who had bacterial growth in their throat swab culture examination and 59 ie 62.8% had no growth and labeled as a viral group. Bacterial group showed significantly higher odds of having positive CRP value compared to viral/nonbacterial group (OR: 3.737, 95% CI: 1.547 – 9.028, p = 0.003).

Conclusion: C-reactive protein can be a diagnostic tool for differentiating bacterial from viral tonsillitis.