口蓋扁桃摘出術が有効であったPFAPA症候群例 : ―習慣性扁桃炎との相違を中心に―

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Periodic fever with aphthous pharyngitis and adenitis (PFAPA) syndrome, which usually occurs in early childhood, features periodic high fever, aphthous stomatitis, tonsillitis, pharyngitis and cervical adenitis. Recurrent tonsillitis during fever becomes an issue for the otolaryngologist. We think PFAPA syndrome is often misdiagnosed as chronic tonsillitis. Although antibiotics are usually prescribed for acute exacerbated chronic tonsillitis, antibiotics are ineffective in PFAPA syndrome, and steroids should be used instead. Differentiating PFAPA syndrome from chronic tonsillitis is thus a priority. In recent reports on tonsillectomy efficacy, surgery is an option for managing PFAPA syndrome. In our cases of a 4-year-old girl diagnosed clinically with PFAPA syndrome, tonsillectomy proved effective. Unlike chronic tonsillitis, PFAPA syndrome recurs regularly every 3-8 weeks, enabling tonsillectomy to be timed relatively easily. We review the literature and discuss clinical PFAPA syndrome features and management.