ArticleCureus2025
Late-Onset Periodic Fever, Aphthous Stomatitis, Pharyngitis and Cervical Adenitis (PFAPA) Syndrome: A Cue for Antimicrobial Stewardship.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
PFAPA is an auto-inflammatory syndrome, characterised by periodic fever, aphthous stomatitis, pharyngitis and cervical adenitis, most commonly described in children. We report two cases of late-onset PFAPA syndrome: a 24-year-old woman and a 28-year-old man, presenting to our tertiary care center in India. In both cases, the diagnosis of PFAPA was made clinically and the patients responded well to treatment with corticosteroids. Late-onset PFAPA syndrome is an emerging but under-recognised clinical entity. Its diagnosis in adults is challenging due to overlap with conditions causing recurrent fever like chronic infections as well as a general lack of awareness of its occurrence in adults. The natural history and long-term outcomes of PFAPA in adults are not yet well-established. Recognising PFAPA or similar auto-inflammatory syndromes in the list of differentials for patients presenting with recurrent fever will help to avoid the misuse of antimicrobial therapies and facilitate targeted management.
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