Dealing with PANDAS: Strep infection in kids may up risk of mental illness

Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS), as per the National Institute of Mental Health (NIMH), is a disorder that develops after a child has a streptococcal infection. The condition triggers a misdirected immune response leading to inflammation in the brain, which in turn leads to the exhibition of certain life-changing effects, such as obsessive-compulsive disorder (OCD), anxiety, tic disorder, personality changes, decline in math and handwriting abilities, sensory sensitivities, restrictive eating, etc.

According to the NIMH, PANDAS is known as a pediatric disorder that typically begins to appear in the age group of three years to puberty and is more commonly diagnosed in boys. Although the condition is rare in adolescents, it can sometimes affect teenagers after 12 years of age, but is rare to affect an individual for the first time as an adult.


One of the factors that can lead to the development of PANDAS is strep bacteria that are ancient organisms living in the human body. These bacteria hide themselves from the immune system by placing molecules on its cell wall which help them look similar to the molecules found on the child’s heart, joints, skin, and brain tissues. This process of hiding on the cell walls, also known as “molecular mimicry,” helps the strep bacteria avoid detection for a long time.

As soon as the human body recognizes strep bacteria as foreign bodies, it starts producing antibodies to fight it. These antibodies attack the “mimicked” strep bacteria, but in the process also harm the normal cells in the brain due to cross-reactivity. These cross-reactive “anti-brain” antibodies target the brain, which in turn leads to the development of OCD, tics, and the other neuropsychiatric symptoms of PANDAS.

Apart from the strep bacteria, other risk factors that can lead to OCD and other mental health disorders include family history of rheumatic fever, mother’s history of having an autoimmune disease, repeated appearance of group A streptococcal infection, etc.

Symptoms and effects

The onset of PANDAS is generally similar to the inflammation of the human brain. While the condition has debilitating effects on some children, such as leaving them homebound and withdrawn from social circles, there are others who can still manage to go to school even when affected by the condition. A child affected by the mental health conditions arising from this disorder usually experiences a dramatic shift in his/her mood and mental health overnight. Similar to the symptoms experienced during OCD and attention-deficit/hyperactivity disorder (ADHD), some of the other symptoms experienced by the individual battling with PANDAS include:

  • motor and/or vocal tics
  • obsessions
  • compulsions
  • separation anxiety
  • mood swings
  • handwriting changes
  • bedwetting
  • disturbed sleep
  • personality changes
  • neurological abnormalities
  • abrupt onset of symptoms
  • joint pains

Treatment and prevention

The best way to treat PANDAS is to use antibiotics prescribed by doctors to treat the strep infection, which is the major cause of the condition. The first step in the treatment is to get a throat culture done. If the throat culture is negative, then tests should be done to look for any hidden strep infections, such as a sinus infection or strep bacteria infecting the anus, vagina, or the urethral opening of the penis.

To avoid PANDAS, it is important for parents to be extra cautious. They should sterilize or replace the kid’s toothbrush during and after the antibiotics treatment. This needs to be done to ensure that the child does not get re-infected with strep. Conducting the throat culture on the family members is also a good idea, as this can help ensure that nobody in the family is the source of infection to the child.

Plasma exchange or immunoglobulin (IVIG) can also be used to end the trouble of strep infection. Helpful to remove a disease substance circulating in the plasma, the procedure involves the separation and removal of the plasma from blood. This treatment works well for depression and mood swings and helps alleviate the symptoms of OCD.

Seeking help

Every child is different. Therefore, one must always remember that the most suitable treatment varies from person to person. If your child has been diagnosed with PANDAS or displays its symptoms, like obsessive-compulsive disorder (OCD), anxiety, tic disorder, etc., it is time to take action.

Seeking help from medical experts is the best way to initiate treatment. At White River Academy – one of the leading therapeutic boarding schools that aims to assist teenage boys in the age group of 12 to 17 years – we have some of the best mental health counselors of the U.S. Call our 24/7 helpline number or chat online with our experts to know about our facility, which is one of the best boarding schools for troubled youth in your vicinity to help your teen recover from his mental illness.

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