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Case Files: Max and his Strep-Induced Psychiatric Illness

I had never seen anyone quite like “Max.”  The plunge from what appeared to be a normal 8 year-old boy to a scared, paranoid, fragile child who was grasping to hold on to reality was striking.  Max knew what many of his doctors had yet to discover, he had a raging strep infection. And, this infection, like many times in the past, would run rampant  in his body, largely undetected, causing him to experience a host of symptoms of serious mental illness.

In 1998, Dr. Susan Swedo, a researcher at the National Institute of Mental Health (NIMH), first described in the scientific literature a subtype of OCD in which children demonstrated an abrupt onset of neuropsychiatric  symptoms (OCD, tics, ADHD-like symptoms, anxiety) preceded by streptococcal infection. This syndrome was termed PANDAS, Pediatric  Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections.  In PANDAS, the body’s immune system is over-reactive to  strep bacteria, leading to psychiatric and neurological symptoms.

The greatest challenge for Max was the professional community’s debate over the very existence of PANDAS/PANS.

2 Comments to
Case Files: Max and his Strep-Induced Psychiatric Illness

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  1. I have an 11 year old daughter with PANDAS. She first exhibited extreme behaviors following a brief illness in Sept. of 2010. It took a full year to get the proper diagnosis and treatment with antibiotics. She was suffering from extreme anxiety and her primary obsessive behavior was hoarding, accompanied by eating disorders due to the fear of vomiting in school among many other strange behaviors. Severe depression and suicidal thoughts were also present.

    When first tested for PANDAS, the results were that one of the antibodies was 7 times normal and the other, 4 times normal. After treatment with antibiotics, the extreme behaviors began to abate but, I feel that complete normalcy did not return for approximately 8 months. She’s not yet experienced a recurrence but, expect that she will and am very happy to know what to do about it immediately. Max’s story is very familiar to me.

  2. I don’t know anyone with PANDAS but I do know a family that has recurrent strep — the kids and parents get it several times every year, and they suspect that sometimes they also have it without the acute symptoms. I wonder how common that is?


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