If the Child Experiences a Fever Every 3-8 Weeks, Beware!

Familial Mediterranean Fever or PFAPA disease may be an underlying fever that recurs in certain periods in children. Yeditepe University Hospital’s Pediatric Health and Diseases, Pediatric Rheumatology and Pediatric Nephrology Specialist Prof. Dr. Ruhan Düşünsel answers questions about childhood fever.

What is the Most Common Cause of Fever in Children?

Upper respiratory tract infections such as influenza, cold, and tonsil infection are the number one cause of fever in childhood. Especially children who come together with their peers in the nursery, kindergarten, or first year of school have upper respiratory tract infections very often. Unfortunately, although the majority of these infections are viruses, they are unnecessarily treated with antibiotics. However, not all febrile infections are treated with antibiotics. If a bacterial agent is detected as the cause by simple laboratory tests, antibiotic treatment is required. In other cases, it is sufficient to provide antipyretic and fluid intake.”

What Does Periodic Fever Syndrome Mean?

It is a group of diseases for which antibiotics have no place in the treatment. The most important feature of fever in these diseases is that it recurs at certain intervals (3-8 weeks).

The most common diseases that cause periodic fever are:

• PFAPA disease in young children. 
• Familial Mediterranean Fever in older children and adults.

What is Pfapa Disease?

It is a fever that recurs every 3 to 8 weeks and lasts for 3-6 days in children under 5 years of age, with normal growth and development. The fever begins suddenly with chills, rising to 38.9-41.1 degrees. Fever is accompanied by bilateral neck glands, pharyngitis, and aphthae. Fever decreases with a single dose of cortisone. A second dose may be required in a small number of patients when fever recurs within 48-72 hours. The majority of patients are between the ages of 2-5. It is more common in boys. Attacks end before the age of 10, and there are rarely adult cases.

What Kind of Picture Occurs in Familial Mediterranean Fever?

Familial Mediterranean Fever is an inherited disease. It is the most common periodic fever syndrome in our country. Although it can be seen at any age, 80 percent of patients are diagnosed before the age of 10. Fever is accompanied by signs and symptoms such as abdominal pain, joint pain, chest pain, joint swelling, and rash. Its diagnosis is based on the presence of clinical signs and symptoms. It is the only periodic fever syndrome that can be treated with colchicine.

What Diseases Is Periodic Fever Confused With?

Connective tissue diseases (such as lupus, Sjögren's syndrome), Chronic infections, and Cancers can also cause periodic, intermittent, or continuous fever. In such diseases, fever is accompanied by other signs and symptoms such as rash, muscle and joint pain, weakness, and pallor. In these cases, the patient should be evaluated by specialties such as pediatric rheumatology, infection, hematology, and oncology.

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