Doctor's Notes on PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections)
PANDAS, which stands for Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections, is a pediatric disease characterized by sudden and dramatic symptoms of obsessive-compulsive disorder (OCD) and/or tic disorders, or worsening OCD, and/or tics following a strep infection.
PANDAS affects children from age 3 to puberty, and rarely, adolescents. Strep bacteria causes PANDAS. This bacteria causes scarlet fever and strep throat.
Symptoms and signs of PANDAS include obsessions and/or compulsions and motor and/or vocal tics. Other symptoms of PANDAS include the following:
- ADHD symptoms (hyperactivity, inattention, and fidgeting)
- Separation anxiety (child has difficulty separating from parents or caregivers)
- Mood changes, such as irritability, sadness, anxiety attacks, excessive emotional reactions (affect lability) such as a tendency to laugh or cry unexpectedly or inappropriately
- Trouble sleeping (insomnia)
- Overnight bed-wetting and/or frequent daytime urination
- Changes in motor skills (for example, changes in handwriting)
- Joint pain
What Is the Treatment for PANDAS?
Firstly, the strep infection that precipitated the condition must be treated with antibiotics. Other treatments for PANDAS can include controlling the symptoms of obsessive-compulsive disorders with selective serotonin reuptake inhibitor (SSRI) medications.
For very severe cases, treatments have been studied that are directed at controlling the immune response. Examples include:
- immunoglobulin treatments,
- steroid medications, and
- plasmapheresis (a procedure in which blood is withdrawn from an individual and the liquid portion is removed and replaced and the blood is transfused back into the individual).
Strep (Streptococcal) Throat Infection : Test Your Infectious Disease IQ Quiz

Just about any painful sore throat is caused by strep.
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Obsessive Compulsive Disorder (OCD)
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Scarlet Fever
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Separation Anxiety
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Strep Throat
Strep throat is a disease caused by infection with streptococcal bacteria. Strep throat is contagious. Strep throat symptoms include fever, pain, redness, and swelling of the throat and tonsils, swollen lymph nodes, white or yellow patches on the back of the throat. Treatment for strep throat includes home remedies to sooth symptoms such as throat lozenges, OTC medications, herbal teas to sooth the throat, and hydration. Medical treatment for strep throat includes antibiotics to prevent complications. -
What Are the Symptoms of PANDAS?
Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a pediatric disease with a sudden and dramatic appearance of symptoms of obsessive-compulsive disorder (OCD) and/or tic disorders, or worsening of OCD and/or tics following a strep infection such as strep throat or scarlet fever.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.