- Clinical and microbiological features of PFAPA-like recurrent febrile episodes in children: a two-center descriptive study
Clinical and microbiological features of PFAPA-like recurrent febrile episodes in children: a two-center descriptive study
Modern Pediatrics. Ukraine. (2026).3(155): 17-25. doi: 10.15574/SP.2026.3(155).1725
Markov I. S.1,2, Markov A. I.1,2,3, Seriakova I. Yu.3, Kramarov S. O.3, Yevtushenko V. V.3, Kyrytsia N. S.3, Shadrin V. O.3, .3
1Vitacell Clinic, Kyiv, Ukraine
2Markov Clinic, Kyiv, Ukraine
3Bogomolets National Medical University, Kyiv, Ukraine
For citation: Markov IS, Markov AI, Seriakova IYu, Kramarov SO, Yevtushenko VV, Kyrytsia NS et al. (2026). Clinical and microbiological features of PFAPA-like recurrent febrile episodes in children: a two-center descriptive study. Modern Pediatrics. Ukraine. 3(155): 17-25. doi: 10.15574/SP.2026.3(155).1725.
Article received: Dec 28, 2025. Accepted for publication: Apr 13, 2026.
Aim – to establish the etiological origin of Marshall syndrome and the periodic fever.
Materials and methods. A two-center retrospective descriptive study was conducted involving 721 children aged from infancy to 14 years with recurrent febrile seizures, who were examined in 2009–2020. The control groups consisted of 205 healthy infants and 70 healthy adults.
Results. A preliminary diagnosis of Marshall syndrome was established in 14 children. All patients with febrile attacks and signs of PFAPA syndrome had foci of chronic bacterial infection in the kidneys and nasopharynx. In 73.6% of cases, nephrodysbacteriosis was diagnosed without clinical and laboratory signs of kidney inflammation.
Conclusions. Febrile attacks in children were accompanied by typical manifestations of PFAPA syndrome and systemic symptoms of intoxication. The data obtained indicate a possible connection of local manifestations with chronic nasopharyngeal infection, and recurrent fever with chronic bacterial intoxication syndrome associated with persistent bacterial focus in the kidneys.
The study was carried out in accordance with the principles of the Declaration of Helsinki. Informed consent was obtained from the patients
The authors declare no conflict of interest.
Keywords: febrile attack, Marshall syndrome, PFAPA-syndrome, nephrodysbacteriosis, chronic bacterial intoxication syndrome.
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