Of all the reasons parents bring sick children in to see me, concern about strep throat is easily in the top ten.

The most typical presentation of this illness is a combination of fever and sore throat, the latter appearing bright red and inflamed on examination. After a short course of an antibiotic like penicillin, the vast majority of kids are back to good health in no time.

For an unlucky few, however, strep might cause something else—the opening act of a much more serious condition that attacks not the throat but the mind: Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections, or PANDAS.