My DS has only ever had strep twice that we know of. The first time was before PANDAS, and he was 3. He had an awful sore throat, high fever, and was miserable for 3 days but had no PANDAS symptoms. The second time he got strep he had no sore throat, fever, or any other symptoms. Instead he developed tics, OCD, and hyperactivity. That was the beginning of his PANS journey.
I wonder if it is different strains of strep that might be responsible for the PANDAS reaction.