Posted on August 04, 2017
By: Dr. Bruce Thomas

     When doctors insist on treating strep throat with amoxicillin, they want to make you better faster but the usually unspoken hope is to prevent Rheumatic Fever.  That’s still around but it was more a scourge of our great grandparents who would get a strep throat and their bodies, and in an attempt to kill it, would make antibodies to it which would sometimes react not only against the strep but their own heart valve, leading to a valve infection, the Rheumatic fever.  That process has also been found to cause a kidney disease, Post Strep Glomerulonephritis, and Sydenham’s Chorea, a  strange neurologic disorder in children producing rapid, irregular, and aimless involuntary movements of the arms and legs, trunk, and facial muscles.
     As if that wasn’t enough, 20 years ago Dr. Susan Swedo discovered another such condition, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Strep, PANDAS. In PANDAS the immune system in susceptible children causes a previously normal child to experience Obsessions, Compulsion or Tics along with new onset of other neuropsychiatric symptoms like :  
  • Anxiety
  • Emotional lability, irritability
  • Deterioration in school performance
  • Behavioral regression
  • Sensory or motor abnormalities
  • Sleep disturbance
  • Food avoidance
  • Handwriting difficulties 
    If that happens, we need to double down on treating the strep infection but sometimes that’s just not enough and you have to calm down the immune system itself.  Fortunately, there is an entire network of doctors interested in PANDAS and its cousin PANS which occurs when similar symptoms result from other causes besides Groups A streptococcus,
     All of this should serve to remind us that while we do get over most childhood infections, some linger and need more evaluation.  Further, that while stress is bad and emotional trauma is real, not mental disorders are “just in your head.”