Periodic fever

Infectious causes
Mycobacteria (TB and non-tuberculous disease)
Streptobacillus moniliformis (rat bite fever)
Hepatitis B
Rickettsea (typhus)
Entamoeba histolytica
Cyclical neutropoenia
Hyper IgD (HIDS)
Familial Mediterranean fever
Familial Hibernian fever/TRAPS
Cryopyrin disorder

Periodic fevers are defined as uniform periods of fever that recur regularly in individuals who are healthy between attacks. Parents may organize life eg holidays around expected attacks and don’t have any concerns otherwise cf child with recurrent respiratory and gastrointestinal infections after starting nursery who “always has something”.

Recurrent bacterial infections esp recurrent/chronic pneumonia or otitis media may indicate a humoral immune defectSimilarly, recurrent documented viral or fungal infections may indicate a cell mediated immune defect.

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