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Recurring Fevers: A Potential Sign of Periodic Fever Syndrome

March 17, 2021

Fevers are one of many childhood ailments that are worrisome to parents, causing parents to miss work and children to miss school. According to Simona Nativ, MD, director of pediatric rheumatology for Goryeb Children’s Hospital, the most common cause of fevers is infection. “Fevers can be healthy; they can be good,” says Dr. Nativ. “They are an indication that our body is trying to fight off infections.”

Dr. Nativ says when a child has a fever, a temperature greater than 100.4, it usually represents some type of infection. But when fevers occur on a regular patterned basis and with recurring symptoms without any clear diagnosis, additional interventions and evaluation with a pediatric rheumatologist may be necessary. This type of situation may be reflective of a periodic fever syndrome, an umbrella term which encompasses numerous distinct disorders that are autoinflammatory in nature.

Dr. Nativ states, “During this pandemic we are evaluating a larger than usual number of patients with recurrent fevers, partly due to the lack of school and daycare exposures.” 

The most common of these disorders is PFAPA (periodic fever, aphthous stomatitis, pharyngitis, adenitis), a disorder which typically occurs in younger children and tends to resolve by early adolescence. Children will experience recurrent patterned fevers in association with
oral sores, sore throat, and lymph node swelling. 

There are numerous ways to treat PFAPA and the other autoinflammatory periodic fever syndromes, says Dr. Nativ. These treatments range from supportive medications such as Tylenol® and Motrin® to biologic medications which specifically target molecules that cause inflammation. 

Patients who are suspected of having unidentified recurrent fever syndrome should be referred to and evaluated by a pediatric rheumatologist.

Dr. Nativ is part of Atlantic Medical Group, a multispecialty network of health care providers. She can be reached at 973-971-4096.