Eight-year-old patient with no relevant personal or family history.
She came to the emergency room because she suddenly presents coprolalia, selective memory disorder (she does not remember and confuses some names). She has a catarrhal process with odynophagia without fever.
There is no loss of consciousness or alteration of muscle tone or strength.
The family describes the condition as an explosive and surprising behavioral alteration.
The episode lasts a few minutes and arrives at the Emergency Room more often, although it still presents language impairment and confusion in relation to the family and the environment in which it is located.
Feeling cold and sore throat
It's scary.
No rashes were observed on physical examination; cardiopulmonary auscultation was normal.
Otorhinolaryngological diagnosis.
Abdomen: blando, without visceromegaly.
Sensitivity, tone, strength and osteotendinous reflexes are normal.
There are no signs of neurological focality.
Blood tests showed 18 400 leukocytes (86 segmented, three cavitated, six lymphocytes, three monocytes), and 260 000 platelets.
Biochemistry showed no alterations in basic screening, C-reactive protein (CRP) 11 mg/l.
Throat smears positive for Streptococcus pyogenes (group A) were collected.
She was admitted for observation and study of the process, and antibiotic treatment with amoxicillin was started, which ended after ten days.
Neuropsychiatric symptoms disappear completely 24 hours after admission.
Given the rapid resolution and good general condition of the child, it was decided to hospital discharge and continue with outpatient study.
When we see him in the Primary Care clinic the patient is asymptomatic, with physical and neurological examination without alterations.
Magnetic resonance imaging and electroencephalogram were requested, which were normal.
It is seen by a catarrhal process at three months, without repeating the symptoms described in the previous episode of colitis.
She remains without relapses.
The patient was studied twice due to a negative infectious process.
The carrier status is also ruled out, although levels of antistreptococcal O (ASLO) antibodies have not been determined for not having presented clinical relapses.
