Pediatric acute-onset neuropsychiatric syndrome in a 6.5-year-old boy: A case report

Background: “Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections”, or PANDAS, is a syndrome characterized by acute-onset obsessive-compulsive disorder (OCD) and/or tics accompanied by the neuropsychiatric symptoms. This case is reported because of its rarity. Case report: A 6.5-year-old boy with swollen tonsils, high-grade fever and rash was admitted to Amirkola Children’s Hospital, Northern Iran. Thereafter he got involved with tachycardia, hypotension, suppurative conjunctivitis and swelling of extensor surfaces of extremities. In addition, after the onset of fever, he had some neuropsychiatric problems such as social isolation, irritability, aggression, oppositional behavior, behavioral regress, unusual sound production, repeated vilifications, loss of appetite and handwriting deterioration. He was treated with intravenous immunoglobulin (IVIG). The patient was discharged from the hospital in a good condition. Conclusions: The medical treatment of underlying disease leads to remarkable patient's neuropsychological and OCD symptoms. PANDAS should be diagnosed in the streptococcal infections associated with abrupt behavioral symptoms and treated with IVIG and antibiotics.