The sphenoid sinuses are way back near the pituitary gland and are very hard to treat without IV antibiotics, because they are so isolated. My son appears to have one of these lovely, uncommon infections. Our pediatrician referred us to an ENT. He's had the infection for a month, and it went away, just a little, for a week with augmentin. He has had PANDAS symptoms along with it--OCD, ADHD, ODD, separation anxiety, pee obsessions, etc. We're on this. It may be far fetched, but could the autoimmune reaction to strep start in these sinuses and make it's way to the basal ganglia through this area? These sinuses have a few tiny blood vessel connections to the brain and can cause menangitis, so what about PANDAS??? Any thoughts?? Thank you in advance.