IN WHICH DISEASES IS A PERIODIC FEVER PATTERN MOST COMMONLY OBSERVED?

In Which Diseases Is a Periodic Fever Pattern Most Commonly Observed?

In Which Diseases Is a Periodic Fever Pattern Most Commonly Observed?

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A periodic fever is a type of fever that recurs at regular or irregular intervals, often with symptom-free periods in between. Unlike continuous or remittent fevers, periodic fever follows a predictable cycle, which can be daily, weekly, or monthly depending on the underlying condition. This distinct pattern helps clinicians narrow down potential causes and make more accurate diagnoses, and it is recognized as one of the 12 types of fever.

Common Diseases with Periodic Fever Pattern

  1. Malaria
    Malaria is a well-known cause of periodic fever. The fever recurs in cycles depending on the Plasmodium species:

    • Plasmodium vivax and P. ovale: fever every 48 hours (tertian malaria)

    • Plasmodium malariae: fever every 72 hours (quartan malaria)

    • Plasmodium falciparum: irregular fever, but can still show periodicity in some cases

  2. Cyclic Neutropenia
    This rare blood disorder is marked by regular drops in neutrophil counts approximately every 21 days, leading to periodic fever, mouth ulcers, and infections during these low-count phases.

  3. Familial Mediterranean Fever (FMF)
    FMF is an inherited inflammatory disorder that causes recurrent episodes of fever, abdominal pain, chest pain, and joint inflammation. Fevers often last 1 to 3 days and recur unpredictably, but with a consistent pattern for each individual.

  4. Still’s Disease (Systemic-onset Juvenile Idiopathic Arthritis)
    This inflammatory condition in children (and sometimes adults) presents with high, spiking fevers that typically occur once or twice daily, often in the evening, and return to normal between episodes.

  5. Hyper-IgD Syndrome (HIDS)
    A rare genetic disorder that causes periodic fever every 4 to 6 weeks, often with abdominal pain, joint aches, and skin rashes. It is due to a metabolic issue affecting immune system regulation.

  6. Tumor Necrosis Factor Receptor-Associated Periodic Syndrome (TRAPS)
    TRAPS is an autoinflammatory condition characterized by prolonged fever episodes (often lasting more than a week), accompanied by muscle pain, skin rashes, and abdominal discomfort.

  7. Brucellosis
    This bacterial infection can sometimes cause undulating or periodic fever patterns, particularly in its chronic form. Fever may rise and fall over days or weeks, often accompanied by fatigue and muscle pain.

  8. Hodgkin’s Lymphoma
    In rare cases, Hodgkin’s lymphoma may present with Pel-Ebstein fever—a cyclical fever pattern with several days of high fever followed by afebrile periods. Though debated, this pattern has been historically associated with this cancer.

Conclusion

Periodic fever is a diagnostic clue in several infectious, inflammatory, and genetic conditions. Its cyclical nature sets it apart from other fever types and can lead physicians toward conditions such as malaria, familial Mediterranean fever, cyclic neutropenia, and certain autoinflammatory syndromes. Identifying the timing, pattern, and associated symptoms of fever episodes is key to reaching a correct diagnosis and providing effective treatment.

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