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CASE REPORT
Neuropsychiatric symptoms following sore throat in a young boy
  1. Raafat Hammad Seroor Jadah1 and
  2. Athar Abdul Mujeeb2
  1. 1 Department of Pediatrics, Bahrain Defence Force Royal Medical Services, Riffa, Bahrain
  2. 2 Department of Pediatrics, Jawaharlal Nehru Medical College, Aligarh, Uttar Pradesh, India
  1. Correspondence to Dr Raafat Hammad Seroor Jadah, nader212{at}hotmail.com

Abstract

A previously healthy 6-year-old boy was referred to us by his primary provider, with a history of sudden onset behavioural abnormalities including irritability, sleep disturbance and anxiety. Physical examination revealed no significant findings; further analyses were not suggestive of meningitis, encephalitis, metabolic abnormalities, toxicity or any other obvious cause. On rechecking the patient’s history, an episode of throat pain 1 week prior to the symptom onset was noted. Therefore, the possibility of paediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) was considered. The antistreptolysin O titre was high (1078 IU/mL), and it increased to 1194 IU/mL 4 weeks later, leading to a diagnosis of PANDAS. He was started on ampicillin and administered one dose of intravenous immunoglobulin. His abnormal behaviours subsided and he returned to a normal state within 48 hours of treatment. This report aims to provide insights into the symptomology and diagnosis of PANDAS in children.

  • child and adolescent psychiatry (paediatrics)
  • paediatrics
  • paediatrics (drugs and medicines)
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Footnotes

  • Patient consent for publication Parental/guardian consent obtained.

  • Contributors RHSJ was involved in patient care as he was the consultant in charge of the concerned patient; he drafted the summary, background and discussion. In addition, he reviewed and improved the paper. AAM was also involved in patient care; he drafted the sections on case presentation, investigations, differentials, follow up and outcome. He also interviewed the mother.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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