The curious case of the "inseparable child"

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Child Psychiatry

Background:

• Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) are rare but serious complications.
• Common PANDAS manifestations include tics, Tourette's syndrome, and obsessive-compulsive disorder.
• Less common presentations involve anxiety disorders and attention deficit hyperactivity disorder.

Purpose of the Study:

• To report a rare case of PANDAS presenting primarily with separation anxiety disorder.
• To emphasize the importance of recognizing unusual neuropsychiatric symptoms in children with streptococcal infections.
• To highlight the need for a high index of suspicion for timely diagnosis and treatment.

Main Methods:

• Case report of a 10-year-old child.
• Clinical presentation analysis focusing on neuropsychiatric symptoms.
• Review of literature on PANDAS and its varied manifestations.

Main Results:

• The patient presented with abrupt onset separation anxiety disorder.
• No other typical PANDAS symptoms like tics or OCD were observed.
• This case illustrates an atypical PANDAS presentation.

Conclusions:

• Streptococcal infections can trigger diverse neuropsychiatric symptoms in children.
• Clinicians must consider PANDAS even with unusual or isolated symptoms.
• Vigilance and a high index of suspicion are crucial for diagnosing and managing PANDAS effectively.