Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-28T03:54:05.906Z Has data issue: false hasContentIssue false

Parapharyngeal abscess in a previously tonsillectomised child with periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome: first reported case

Published online by Cambridge University Press:  26 November 2007

M Rollin*
Affiliation:
Department of Otolaryngology, Royal Free Hospital, London, UK
A Majithia
Affiliation:
Department of Otolaryngology, Royal Free Hospital, London, UK
M Stearns
Affiliation:
Department of Otolaryngology, Royal Free Hospital, London, UK
*
Address for correspondence: Mr Matthew Rollin, Pond street, Hampstead, London NW3, 2QG. Fax: 020 7830 2422 E-mail: [email protected]

Abstract

Objective:

we present the first reported case of parapharyngeal abscess in a child with periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome, an uncommon syndrome of recurrent, self-limiting fever in children.

Method:

Case report and review of the literature to date concerning periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome.

Results:

Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome is an incompletely understood syndrome which requires careful and thorough investigation in order to distinguish it from other causes of recurrent fever. There has been much recent debate in the literature over the merits of various treatment strategies, including tonsillectomy.

Conclusion:

To the authors' knowledge, this is the first reported case of a parapharyngeal abscess in a child with periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome, made more significant by the fact that the child had undergone tonsillectomy one year prior. This case provides evidence that tonsillectomy does not protect against one of the more serious complications of oropharyngeal infection in children with this syndrome.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Marshall, GS, Edwards, KM, Lawton, AR. PFAPA syndrome. Paediatr Infect Dis J 1989;8:658–9CrossRefGoogle ScholarPubMed
2Lee, WI, Yang, MH, Lee, KF, Chen, LC, Lin, SJ, Yeh, KW et al. PFAPA syndrome. Clin Rheumatol 1999;18:207–13CrossRefGoogle ScholarPubMed
3Tasher, D, Somekh, E, Dalal, I. PFAPA syndrome: new clinical aspects disclosed. Arch Dis Child 2006;91:981–4CrossRefGoogle ScholarPubMed
4Long, SS. Syndrome of periodic fever, aphthous stomatitis, pharyngitis and adenitis (PFAPA). J Paediatr 1999;135:15CrossRefGoogle ScholarPubMed
5Scholl, PR. Periodic fever syndromes. Curr Opin Pediatr 2000;12:563–6CrossRefGoogle ScholarPubMed
6Padeh, S, Brezniak, N, Zemer, D, Pras, E, Livneh, A, Langevitz, P et al. Periodic fever, aphthous stomatitis, pharyngitis, and adenopathy syndrome: clinical characteristics and outcome. J Pediatr 1999;135:98101CrossRefGoogle ScholarPubMed
7Dahn, KA, Glode, MP, Chan, KH. Periodic fever and pharyngitis in young children: a new disease for the otolaryngologist? Arch Otolaryngol Head Neck Surg 2000;126:1146–9CrossRefGoogle ScholarPubMed
8Parikh, SR, Reiter, ER, Kenna, MA, Roberson, D. Utility of tonsillectomy in 2 patients with the syndrome of periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. Arch Otolaryngol Head Neck Surg 2003;129:670–3CrossRefGoogle ScholarPubMed
9Cazeneuve, C, Genevieve, D, Amselem, S, Hentgen, V, Hau, I, Reinert, P. MEFV gene analysis in PFAPA. J Pediatr 2003;143:140–1CrossRefGoogle ScholarPubMed
10Frenkel, J, Kuis, W. Overt and occult rheumatic diseases: the child with chronic fever. Best Pract Res Clin Rheumatol 2002;16:443–69CrossRefGoogle ScholarPubMed
11Maschio, M, Oretti, C, Ventura, G, Pontillo, A, Tommasini A. CARD15/NOD2 mutations are not related to abdominal PFAPA. J Pediatr 2006;149:427CrossRefGoogle Scholar
12Yoshihara, T, Imamura, T, Yokoi, K, Shibata, M, Kano, G, Osone, S et al. Potential use of procalcitonin concentrations as a diagnostic marker of the PFAPA syndrome. Eur J Pediatr 2007;166:621–2CrossRefGoogle ScholarPubMed
13Frye, RE. Recurrent aseptic encephalitis in periodic fever, aphthous stomatitis, pharyngitis and adenopathy (PFAPA) syndrome. Pediatr Infect Dis J 2006;25:463–5CrossRefGoogle ScholarPubMed
14Stojanov, S, Hoffmann, F, Kery, A, Renner, ED, Hartl, D, Lohse, P et al. Cytokine profile in PFAPA syndrome suggests continuous inflammation and reduced anti-inflammatory response. Eur Cytokine Netw 2006;17:90–7Google ScholarPubMed
15Pinto, A, Lindemeyer, RG, Sollecito, TP. The PFAPA syndrome in oral medicine: differential diagnosis and treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:35–9CrossRefGoogle ScholarPubMed
16Leong, SC, Karkos, PD, Apostolidou, MT. Is there a role for the otolaryngologist in PFAPA syndrome? A systematic review. Int J Pediatr Otorhinolaryngol 2006;70:1841–5CrossRefGoogle Scholar
17Galanakis, E, Papadakis, CE, Giannoussi, E, Karatzanis, AD, Bitsori, M, Helidonis, ES. PFAPA syndrome in children evaluated for tonsillectomy. Arch Dis Child 2002;86:434–5CrossRefGoogle ScholarPubMed
18Hernandez-Bou, S, Giner, M, Plaza, AM, Sierra, JI, Martin Mateos, MA. PFAPA syndrome: with regard to a case [in English and Spanish]. Allergol Immunopathol (Madr) 2003;31:236–9CrossRefGoogle ScholarPubMed