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Parapharyngeal abscess in a previously tonsillectomised child with periodic fever, aphthous stomatitis, pharyngitis

M Rollin1, A Majithia, M Stearns

  • 1Department of Otolaryngology, Royal Free Hospital, London, UK. matthew@rollinfamily.net

The Journal of Laryngology and Otology
|November 27, 2007
PubMed

Insights

This case report details a parapharyngeal abscess in a child with periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA). It highlights that tonsillectomy does not prevent serious complications in PFAPA patients.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Genetics and Hereditary Diseases

Background:

  • Periodic fever, aphthous stomatitis, pharyngitis, and adenitis syndrome (PFAPA) is a common autoinflammatory disorder in children.
  • PFAPA is characterized by recurrent episodes of fever, aphthous ulcers, pharyngitis, and cervical adenitis.
  • The etiology of PFAPA remains largely unknown, but genetic and environmental factors are suspected.

Observation:

  • A pediatric patient with PFAPA developed a parapharyngeal abscess.
  • The patient had a history of tonsillectomy one year prior to the abscess.
  • This presentation is the first reported instance of a parapharyngeal abscess in a child with PFAPA.

Findings:

  • PFAPA requires thorough investigation to differentiate it from other causes of recurrent fever.
  • There is ongoing debate regarding optimal treatment strategies for PFAPA, including the role of tonsillectomy.
  • This case suggests that tonsillectomy may not confer protection against severe oropharyngeal infections in PFAPA patients.

Implications:

  • This case underscores the potential for serious complications, such as parapharyngeal abscess, in children with PFAPA.
  • It challenges the notion that tonsillectomy eliminates the risk of such complications.
  • Further research is needed to elucidate the pathophysiology of PFAPA and refine management guidelines.
Abstract

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