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In 1998, Swedo and colleagues described pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS) as a syndrome of tics, obsessive-compulsive disorders (OCDs), or both that followed group A streptococcal (GAS) infection. In the ensuing decade, contradictory and controversial studies have been published about the role of streptococcal infections in the onset of disease and exacerbations and the need for prophylactic antibiotics. Results from two recent studies add considerable doubt to the hypothesis that GAS infection is a precipitating factor in most episodes of PANDAS exacerbation.
In a prospective, 2-year, multicenter, case-control study, researchers compared 40 patients who met criteria for PANDAS …