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After suffering with OCD and intrusive thoughts for over 3 1/2 years, we finally were able to get a rheumatologist to prescribe a high dose of Augmentin for 30 days for our DS in 2016. During the 3 1/2 years we tried unsuccessfully to treat his symptoms with pharmaceutical meds. The doctor let us start the abx before his bloodwork came back, which ultimately showed normal Strep titers. She said we may continue the abx for the 30 days if we chose to. He had no response for the first ten days, but on day 11 or so his symptoms began to rapidly improve. Again, his bloodwork had come back normal. I think if the infection was too far in the past it doesn’t show up on the bloodwork, although the misfired antibodies continue to attack the brain. The Cunningham Panel is what got the PANS diagnosis for my DS. With PANS, there are 3 things to address: the infection, the inflammation and the immune response.