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: Alan A Z Alexander, Nitin J Patel, Cathy A Southammakosane, Melissa M Mortensen
• Journal: International journal of pediatric otorhinolaryngology (Int J Pediatr Otorhinolaryngol) Vol. 75 Issue 6 Pg. 872-3 (Jun 2011) ISSN: 1872-8464 [Electronic] Ireland
• PMID: 21466900 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Topics

• Autoimmune Diseases (diagnosis, etiology, surgery)
• Child
• Humans
• Male
• Mental Disorders (microbiology, therapy)
• Obsessive-Compulsive Disorder
• Recurrence
• Streptococcal Infections (diagnosis, etiology, surgery)
• Streptococcus pyogenes
• Tonsillectomy