KBB-Forum 2006 , Cilt 5, Sayı 4

A RARE CAUSE OF HIGH FEVER—PFAPA SYNDROME

Erdinç AYDIN, MD1; Seda TÜRKOĞLU, MD2; Zekai AVCI, MD3
1Baskent University Faculty of Medicine, Department of Otorhinolaryngology, Ankara, Turkey
2Baskent University Faculty of Medicine, Department of Pediatrics, Ankara, Turkey
High fevers of unknown origin are common in infants and children. Recurrent fever is also common. A clinical entity of periodic fever associated with aphthous stomatitis, pharyngitis, and cervical adenitis, termed PFAPA syndrome, was first described by Marshall and coworkers in 1985. The etiology of PFAPA syndrome remains unknown, and treatment so far is not definitive. However, glucocorticoids are highly effective in controlling symptoms. Anecdotally, cimetidine and steroids have decreased illness duration. Several reports of complete resolution of symptoms after tonsillectomy have been published. We describe a patient with recurrent pharyngitis, fever, and cervical adenitis who is refractory to antibiotic therapy and antipyretics. The syndrome complex lasted for 4-6 days, with complete resolution of symptoms with corticosteroid use. A physical examination including bacterial cultures, chest radiographs, and blood analyses to determine the syndrome's etiology was inconclusive. The patient was diagnosed with PFAPA syndrome and following tonsillectomy, has remained symptom free. Keywords : Fever, tonsillectomy