Abstract
We report the case of a 6-year-old girl who presented with hypoglycemic and dehydration symptoms with acute obsessive compulsive behavior and eating restriction after suffering from streptococcal infection a half year ago.The patient exhibited repeated behavior of wearing clothes in the morning and rituals before eating a week before presentation without triggers. She was admitted to the hospital because her repeated act became extended, resulting in a failure to eat. Dehydration and hypoglycemia appeared. There were no significant findings on brain magnetic resonance imaging or in the tests conducted on the cerebral spinal fluid. After being provided hydration and glucose, the condition of the patient improved, and she was discharged from the hospital. After 18 months, the obsessive compulsive disorder (OCD) symptoms reappeared. Group A Streptococcus was detected via throat culture. Her condition gradually improved with observation in an outpatient clinic without medication for a month. From the clinical course, Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal infections（PANDAS）or Pediatric Acute-onset Neuropsychiatric Syndrome（PANS） as a disease concept encompassing acute onset OCD symptoms without apparent prior infection was suspected. It is desirable to accumulate similar case reports in the future.
