What is PFAPA

PFAPA is an inflammatory syndrome that causes repeated episodes of fever, usually along with mouth sores, sore throat, or swollen neck glands. This page offers a short and clear explanation for families and curious visitors.

A simple explanation

PFAPA stands for periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis. It is considered an autoinflammatory syndrome rather than a contagious infection, and it often appears in episodes with some regularity.

PFAPA is also known as Marshall syndrome with periodic fever, listed as a synonym in Orphanet · PFAPA (ORPHA:42642) ↗.

Between episodes, many children look well, return to their normal routine, and grow as expected. That is one reason why organized tracking can help identify patterns and support conversations with a pediatrician.

Most relevant facts

What the letters mean

PFAPA summarizes four common findings: periodic fever, mouth ulcers, throat inflammation, and enlarged neck glands.

How episodes often appear

Episodes often come back every few weeks and may last several days. In many families the pattern becomes fairly predictable.

It is usually not contagious

PFAPA is not generally described as an infection that spreads from one person to another. Even so, symptoms should be assessed by healthcare professionals to rule out other causes.

Most noticeable symptoms

Recurrent high fever

Fever comes in repeated episodes and is often the symptom families notice most.

Sore or inflamed throat

During an episode there may be pharyngitis, redness, or pain when swallowing.

Mouth sores

Some children develop small painful sores inside the mouth.

Swollen neck glands

Enlarged cervical lymph nodes are commonly noticed during flares.

Other possible symptoms

Some children may also have malaise, abdominal pain, headache, joint pain, or tiredness.

Well between episodes

Outside flare periods, many children feel well and do not show obvious symptoms.

Typical age range

Most common onset

PFAPA usually begins in early childhood, often between ages 2 and 5, and frequently before age 5.

Typical course

In many children the episodes become less frequent over time, and the condition may resolve in later childhood or before adolescence.

Not always the same

Some cases may persist longer or appear at older ages, which is why medical evaluation still matters.

When to seek medical guidance

If your child has repeated fevers, it is appropriate to talk with a pediatrician to evaluate the cause and rule out other conditions.
If fever comes with breathing difficulty, dehydration, marked drowsiness, or other warning signs, seek urgent care.
Tracking dates, duration, temperature, and symptoms can be very helpful during evaluation.

This information is general and does not replace diagnosis or instructions from healthcare professionals.