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Do PANS kids flare with viruses, too?


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I'm wondering whether PANS kids normally flare with viruses, or only with infections, or both?


10 yo DD has been doing really well on daily Amoxicillin since being dx'd w/ PANS in June. She's been doing so well that two weeks ago the (PANS-friendly) Dr. reduced her Amoxicillin dose a prophylactic strength vs. an active-infection-fighting strength dose.


Two days ago, DD's mood changed from happy to irrationally irritable, more anxious than normal, and generally moody, but no OCD, Tics, or Chorea. That same evening she complained of a sore throat, however she didn't have a fever and was eating normally (for her). Yesterday she was the same, still no fever. We took her to the Dr who noted and that her tonsils were very enlarged and saw that her mood was different from normal, but the Dr saw none of the"classic" signs of strep or other infections/illnesses. DD refused a throat swab (severe anxiety) so we decided to treat it as an infection and resume the original Amoxicillin dose strength. We didn't do blood tests because DD was already in meltdown over just the mention of the word "swab". We gave her the new dose at 5PM yesterday, and by 9PM she was "easier". This morning she woke up singing and happy and generally back to normal.


You could argue that either she has/had an infection and the Amoxicillin is addressing the problem, or you could argue that she gets irritable and moody when she's sick just like the rest of us, and that she has/had a virus and she just happens to be feeling better this morning.


Thanks in advance for your insight.



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The drs we see have told me that stress, allergies, infections or viruses could trigger flares. So I would say yes that whatever illness your daughter was fighting caused a flare. Not all flares are the same.


Also, the reduction of the amoxicillin could be a factor too. My daughter was on amoxicillin (prophylactic dose) from Feb-July. We took her off the amoxicillin for the summer and within a week she was flaring and within in 2 weeks she was really struggling. We put her back on amoxicillin but we could not get back to 100%. One of her dr said that although the body does not get resistant to amoxicilin maybe the saliva in the mouth was breaking down the strength. So we moved her to Cephalexin and she is doing much better. So you might want to keep her on a higher dose and see if that helps her maintain.

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