Related Experiment Video

Updated: Jun 17, 2025

CO2-Lasertonsillotomy Under Local Anesthesia in Adults
05:07

CO2-Lasertonsillotomy Under Local Anesthesia in Adults

Published on: November 6, 2019

24.3K

Risk of immediate postoperative fever in PFAPA patients undergoing tonsillectomy

Ory Madgar1, Amber D Shaffer2, David H Chi2

  • 1Division of Pediatric Otolaryngology, Children's Hospital of Pittsburgh UPMC, Pittsburgh, PA, USA; Department of Otolaryngology, Head and Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel; Faculty of Medicine, Tel-Aviv University, Israel.

American Journal of Otolaryngology
|August 7, 2024
PubMed

Insights

Patients with Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) syndrome do not face an increased risk of immediate postoperative fever after tonsillectomy. This study found a low incidence of fever, suggesting current management protocols may be overly cautious.

Area of Science:

  • Pediatric Otolaryngology
  • Pediatric Rheumatology
  • Infectious Diseases

Background:

  • Periodic Fever, Aphthous Stomatitis, Pharyngitis, and Cervical Adenitis (PFAPA) syndrome is the most common periodic fever syndrome in children.
  • Tonsillectomy is a potential treatment for PFAPA syndrome.
  • A common clinical concern is the potential for increased postoperative fever in PFAPA patients, complicating diagnosis and management.

Purpose of the Study:

  • To evaluate the incidence of immediate postoperative fever in children with PFAPA syndrome undergoing tonsillectomy.
  • To determine if PFAPA patients have a higher risk of postoperative fever compared to the general pediatric population undergoing tonsillectomy.

Main Methods:

  • Retrospective chart review of PFAPA patients who underwent tonsillectomy at a tertiary children's hospital (2013-2022).
  • Query of the Pediatric Health Information System (PHIS) database for pediatric tonsillectomies and PFAPA diagnoses during the same period.
  • Analysis of immediate postoperative fever rates in PFAPA patients.

Main Results:

  • Only 1.6% of PFAPA patients (1 out of 61) experienced immediate postoperative fever.
  • The incidence of fever episodes significantly decreased post-tonsillectomy in PFAPA patients (100% pre-op vs. 9.75% post-op).
  • Analysis of a large national database (PHIS) showed 0.25% of pediatric tonsillectomies were associated with PFAPA, with no reported immediate postoperative fevers in this subgroup.

Conclusions:

  • The study suggests that PFAPA syndrome is not associated with an increased risk of immediate postoperative fever following tonsillectomy.
  • The findings challenge the notion that PFAPA patients require specialized care at main centers solely due to fever risk post-tonsillectomy.
  • Current institutional practices regarding the management of PFAPA patients undergoing tonsillectomy may warrant re-evaluation based on these results.
Abstract

Keywords:
PFAPAPost-operative feverTonsillectomy

More Related Videos

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management06:43

Esophageal Heat Transfer for Patient Temperature Control and Targeted Temperature Management

Published on: November 21, 2017

24.3K
Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue07:38

Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue

Published on: June 14, 2020

7.5K

Related Concept Videos

Tonsillitis II: Management01:26

Tonsillitis II: Management

This lesson will focus on the different treatment options for managing tonsillitis, which typically depend on the cause and severity.
105
Chronic Pharyngitis01:23

Chronic Pharyngitis

Chronic pharyngitis refers to persistent inflammation of the pharyngial mucosa.
Etiology
It often arises from persistent viral or bacterial infections affecting sinuses and tonsils.
Additional contributing factors include inadequate dental hygiene, mouth breathing, recurring tonsillitis, allergic rhinitis, laryngopharyngeal reflux, and exposure to smoke, chemicals, and other environmental pollutants. Allergic reactions to pollen, mold, and pet dander, chronic cough, excessive voice usage,...
1.5K
Tonsillitis I: Introduction01:30

Tonsillitis I: Introduction

Tonsillitis is inflammation of the tonsils, which are two lymphoid tissue masses at the back of the throat. This condition can cause discomfort and irritation in the throat.
Etiology
Three primary contributing factors have been identified.
217
Acute Pharyngitis01:30

Acute Pharyngitis

Introduction
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
528
Increased Body Temperature01:25

Increased Body Temperature

A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
648
Endotracheal Tube Extubation01:24

Endotracheal Tube Extubation

Endotracheal tube extubation is a critical procedure in weaning patients from mechanical ventilation. It involves physically removing the oral or nasal endotracheal (ET) tube, marking the final step in liberating a patient from ventilatory support.
Procedure
Extubation removes the endotracheal tube (ETT) from the patient on mechanical ventilation. It requires a well-coordinated, multidisciplinary approach involving physicians, nurses, respiratory therapists, and other healthcare professionals....
516