A link between perianal strep and pediatric autoimmune neuropsychiatric disorder associated with streptococcal...

Area of Science:

• Pediatric infectious diseases
• Pediatric neurology
• Immunology

Background:

• Perianal streptococcal dermatitis is a Group A Streptococcus (GAS) infection.
• Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) involves tics or obsessive-compulsive symptoms.
• GAS infections can trigger systemic immune activation, potentially leading to PANDAS phenotypes.

Observation:

• This retrospective case series examined three children presenting with PANDAS-like symptoms.
• All three children had confirmed perianal streptococcal dermatitis.
• The perianal dermatitis was identified as the likely infectious trigger for their neuropsychiatric symptoms.

Findings:

• Group A Streptococcus (GAS) infection in the perianal area can manifest as perianal streptococcal dermatitis.
• This infection may act as a trigger for the development of Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS) in susceptible children.
• Observed symptoms included new-onset obsessive-compulsive behaviors and/or tics in conjunction with the dermatitis.

Implications:

• Concurrent perianal dermatitis and new-onset obsessive-compulsive symptoms or tics in children warrant investigation.
• Perianal cultures and rapid antigen detection tests are recommended for diagnosing GAS in such cases.
• Identifying and treating the underlying streptococcal infection may help manage PANDAS symptoms in pediatric patients.