Pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) in a two-year-old

Area of Science:

• Pediatric infectious diseases
• Pediatric neurology
• Immunology

Background:

• Current guidelines often do not recommend routine testing for streptococcal pharyngitis in children under 3.
• This approach is based on the perceived low incidence and risk of complications in this age group.

Purpose of the Study:

• To highlight the potential for serious complications, including PANDAS, from streptococcal pharyngitis in children under 3.
• To advocate for increased consideration of testing and treatment in this demographic.

Main Methods:

• Case report presentation of a 2-year-old diagnosed with PANDAS secondary to streptococcal pharyngitis.
• Review of existing literature and guidelines regarding streptococcal pharyngitis in young children.

Main Results:

• The case demonstrates that streptococcal pharyngitis and its complications, such as PANDAS, can occur in children under 3.
• Such infections, though potentially underestimated, can lead to significant short- and long-term health issues.

Conclusions:

• Testing and treatment for streptococcal pharyngitis should be strongly considered in children under 3 with clinical signs of infection or suspected immune-mediated complications.
• Early intervention may prevent or mitigate the severity of both acute and chronic sequelae of streptococcal infections in this vulnerable population.