Maintaining differential diagnosis inclusive of infectious etiology may help save children's life

Feb 23 2012

Neurologic tics and obsessive-compulsive behaviors caused by a bacterial infection in children were once thought to occur exclusively in PANDAS (Pediatric Autoimmune Disease Associated with Streptococcus infections).  Despite ongoing controversies regarding Lyme disease and PANDAS, a recent evidence-based review by Daniel J. Cameron, MD, MPH and Hanna Rhee, MD uncovered a little known published report of a child who initially appeared to have PANDAS, but was later found to have Lyme disease.  When the patient was treated with antibiotics for the bacterial infection transmitted by a tick bite, his symptoms resolved.

"Our extensive review of the literature has elucidated the mechanism with which a tick bite or sore throat may develop into neuropsychiatric disorders. TLRs (Toll-like receptors) in haplotype-variable individuals may play a role in multisystemic disease formation," states Dr. Rhee.

"We chose to publish our review paper in the International Journal of General Medicine, an online publication which provides open access to the public so that families and their physicians can download a free copy to reference at their convenience.  In the context of psychiatric pathology, maintaining a differential diagnosis inclusive of an infectious etiology is what may help to save that child's life," reports co-author Dr. Cameron.