Cure for mysterious fevers

Few things are as worrisome to parents as when a child spikes a fever. When the fever goes as high as 104 or 105 degrees, most parents are on the phone with the pediatrician or speeding toward the emergency room. For some children, with a syndrome characterized by unexplained high fevers occurring every few weeks, the usual culprits—infection, or juvenile arthritis—are ruled out, and the cause remains a mystery. Treatments--antibiotics or children’s Motrin or Tylenol--don’t help. Rather, the fever just vanishes on its own in four or five days, only to roar back in a few weeks.

Now, surgeons at Children’s Hospital Boston, reported in the February issue of Archives of Otolaryngology and Head and Neck Surgery that removing the child’s tonsils almost always cures the mysterious condition, even though the tonsils and adenoids appear normal. “Why is unclear, but it works in almost every single kid,” lead author Dr. Greg Licameli says in a press release.

In the largest surgical trial to date, surgeons at Children’s Hospital Boston performed tonsillectomies on 27 children with the syndrome, and for 26 of them, the cyclical fevers didn’t return. Since the study, Licameli has seen a total of 60 children treated for the condition, and the findings remain the same.

His research interest was triggered by his own daughter’s bout with the syndrome. By the time she was 19 months old, she was suffering unexplained fevers every three weeks. He scanned the medical literature for answers and found two case studies in Europe where removal of the tonsils resulted in the children immediately getting better.

Surgeons removed his daughter’s tonsils, and the fever cycles stopped. She's six years old now, and they have not returned.

--Susan Brink

Photo: MedioImages/Corbis