SHM Converge Scientific Abstract ePoster Gallery-Pfapa: Not Just for Kids

Pdf Summary

This case describes a 19-year-old woman with recurrent high fevers, sore throat, body aches, tonsillar enlargement with exudate, and tender cervical adenopathy. She had previously undergone extensive infectious and rheumatologic evaluation for similar episodes, which was unrevealing, and she had improved rapidly with corticosteroids. On this admission, broad microbiologic testing, autoimmune labs, imaging, and biopsies again failed to identify an infectious, malignant, or classic rheumatologic cause.<br /><br />Based on her recurrent pattern of fever and pharyngitis, negative workup, lack of response to antibiotics, and steroid responsiveness, she was diagnosed with PFAPA syndrome (Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis). Although PFAPA was originally described in children and is most common in early childhood, this report emphasizes that it can also present in young adults and should be considered in adults with unexplained recurrent febrile illness.<br /><br />The patient was treated with prednisone 60 mg with taper and colchicine 0.6 mg twice daily for prophylaxis, leading to symptomatic improvement and fever resolution. She was discharged with plans for possible tonsillectomy and confirmatory genetic testing at NIH.<br /><br />Key teaching points are that PFAPA should be considered when patients have recurrent, abrupt fever episodes with pharyngitis and cervical adenitis, minimal upper respiratory symptoms beyond throat involvement, negative infectious studies, no household spread, poor antibiotic response, and prompt improvement after a single dose of corticosteroids.

Asset Subtitle

Margaret Krasne

Meta Tag

Author List Gigi Liu, James Son, Margaret Krasne, Timothy Kaniecki

Category Clinical Vignettes

Concept PFAPA Syndrome

Concept Febrile Illness

Concept Periodic Fever

Concept Pharyngitis

Concept Cervical Adenitis

Distinguished Non-Finalist

Presenter Organization Johns Hopkins Hospital Division of Hospital Medicine

Presenting Author Margaret Krasne

Track Adult

Keywords

PFAPA syndrome

periodic fever

pharyngitis

cervical adenitis

recurrent fever

tonsillar exudate

corticosteroid responsiveness

young adult

colchicine prophylaxis

tonsillectomy

PFAPA Syndrome

Febrile Illness

Periodic Fever

Pharyngitis

Cervical Adenitis