title: Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS): an indication for tonsillectomy.
abstract: Children with obsessive compulsive disorder or tic disorders that are associated with streptococcal infections (Group A beta-hemolytic) in the oro-pharyngeal region are given the diagnosis of pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS). Tonsillectomy has been reported to resolve the neuro-psychiatric symptoms in these children. We have a case of a 9-year-old boy who was seen in our clinic with multiple recurrent streptococcal infections of the oro-pharyngeal cavity. He also exhibited neuro-psychiatric symptoms including agitation, hyperactivity, and tics. These symptoms followed his recurrent infections. Tonsillectomy was performed and in one year follow-up the patient did not have any recurrent streptococcal infections, and his neuro-psychiatric symptoms resolved completely. Guidelines for medical and surgical management of recurrent strep infections in the face of PANDAS are reviewed.
authors.affiliation: University of Virginia, Department of Radiology, Charlottesville, VA 22908, USA. aaz.alexander@yahoo.com
authors.forename: Alan A Z
authors.initials: AA
authors.lastname: Alexander
authors.forename: Nitin J
authors.initials: NJ
authors.lastname: Patel
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Southammakosane
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Mortensen
mesh_terms: D001327:Autoimmune Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D002648:Child; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000382:microbiology* / Q000628:therapy*; D009771:Obsessive-Compulsive Disorder; D012008:Recurrence; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D013297:Streptococcus pyogenes; D014068:Tonsillectomy