Chronic tonsillitis is a frequent disease in the adult population, in which the actinomycotic infection represents a not negligible accompanying phenomenon. Data about the presence of actinomycotic granules in tonsilar crypts are controversial in the available literature sources. Likewise, evaluation of the clinical significance of actinomycetes in the tonsil is reduced to simple saprophytism by some, or is considered infective for the tonsilar tissue by others. The present study assesses the appearance of actinomycetes and the character of their invasiveness in the tonsilar tissue afflicted with chronic tonsillitis. The material consists of surgical specimens from 125 patients between the age of 15 to 78 years. Actinomycotic granules were present in 52 cases (41.6%), in 3 of those (5.8%) no tissue reaction was observed. Most frequently, in 32 of positive cases (61.5%), the granules were in crypts accompanied by abundant accumulation of inflammatory cells. In 16 cases (32.7%), actinomycetes migrated through the epithelium into the tonsilar tissue. The presence of actinomycotic granules was significantly higher in chronic lacunar tonsillitis (72.4%) if compared with chronic tonsillitis cases without dilated crypts (36.3%). Our results indicate that actinomycets may play an active role in the etiology of chronic inflammatory tonsilar disease as the causative factor, or as a factor complicating an antecedent disease.

        Key words: chronic tonsillitis - actinomycosis - tissue invasion