Catatonia in a 6-year-old Patient Following Disseminated Group A Streptococcus Infection.

Pediatric catatonia is a complex entity that is easily missed in the hospital setting and seldom reported in the literature. Here, we present the case of a 6-year-old previously healthy female patient who was initially thought to have intractable delirium secondary to disseminated Group A streptococcus (GAS) infection. Careful examination, utilization of the Pediatric Catatonia Rating Scale, and lorazepam challenge were key to elucidating the diagnosis. While GAS is most often associated with pediatric acute-onset neuropsychiatric syndrome (PANS) in the child and adolescent population, we reviewed the limited literature to suggest a mechanism by which it can lead to catatonia. Further systematic study of catatonia in the pediatric population is warranted to better understand pathogenesis and long-term neuropsychiatric outcomes.