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Court works to untangle battle of parents, doctors, and the state.

Dr. Mark Korson, a soft-spoken, goateed native of Canada, prided himself on always keeping his cool, even when the highly stressed patients and families around him were losing theirs.

Still, as the chief of metabolism at Tufts Medical Center sat in his cluttered third-floor office in Chinatown last April, his frustration began to boil over. Two months earlier, Korson had sent a 14-year-old patient, Justina Pelletier, to Boston Children’s Hospital to see a former colleague of his who had previously treated the girl for gastrointestinal problems. But things had rapidly gotten off track.

Justina has a metabolic disease. Or does she? Her parents and Children’s Hospital deadlocked, she was placed in state custody.

Just after midnight on a Sunday last February, Linda Pelletier climbed into the passenger seat of an ambulance as her ailing teenage daughter lay in the back. They headed for Boston Children’s Hospital, on the advice of one of the girl’s doctors. A crippling storm had dumped 3 feet of snow on parts of New England, and every time the ambulance began to fishtail, Pelletier gasped.

IMAGINE THAT ONE NIGHT you put your bright, athletic, well-adjusted 8-year-old son to bed, a kid who loves playing baseball and cracking jokes and scarfing down chocolate chip cookies. The next morning, he wakes up as someone entirely different, and in subsequent days turns into someone unrecognizable.

He’s manic, spending hours doing sit-ups or running laps on the driveway — unwilling to sit down even for a minute. He alternates between tears of soul-crushing sadness and tantrums of rage directed at you and your spouse. He’s obsessed with the unhealthiness of food, refusing to eat or drink much of anything. More than anything, though, all the comforting touchstones of his life — home, school, even sleep — have suddenly been transformed into dangers. He seems trapped in a horror movie, his fear unmistakable in the way his pupils have overtaken the irises of both his eyes.

As this bizarre behavior continues, you find yourself staring at your formerly normal, healthy son and you can’t help but wonder, Where did my boy go? You ask yourself: Is this what children of Alzheimer’s patients mean when they talk about looking at a loved one who’s no longer there?

Solving a medical mystery – Thank you for making people aware of the concept that strep infections can cause sudden onset of obsessive/compulsive disorder in children [“Little boy, big fears,” Sept. 27. ]

The phenomenon of PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) results in serious behavioral and emotional changes. Countless children and families suffer needlessly, pursuing treatments that can’t be effective until antibiotics are prescribed.

As stated in the article, many cases of OCD develop slowly and are not attributable to PANDAS. But when onset is sudden and dramatic, why not rule out PANDAS by conducting a blood test and administering a trial course of antibiotics?

Christina Teague barely had time to react as her son, Will, lunged for the door of her car full of children, trying to wrench it open while yelling frantically, “I’ve got to get out!” Teague managed to pull to the side of the winding country road near their Charlottesville home as Will, nearly 8, leapt out of the car.

“He kept saying, ‘The car smells funny,’ and refused to get back in,” Teague recalled, astonished that her normally self-possessed second-grader would fall apart in front of his little sister and her friends, who stared, goggle-eyed, from the back seat. When Teague’s efforts at reassurance failed, she called her husband, who left work. After an hour, Will’s father managed to coax their son into his car, and they drove home.

That November 2007 episode was the first of Will’s bizarre and inexplicable meltdowns; it would not be the last. For the next 16 months specialists in three states offered various explanations for why Will had suddenly morphed from a sociable, well-adjusted kid into a fearful boy so beset by crippling obsessions that he refused to sleep alone, go to school or even play with the family dog. “We went from having a fun-loving, independent 8-year-old to a child who was more like a 2- or 3-year-old,” his mother recalled.

Ever wonder why just the right person comes into your life at just the right moment sometimes? I think everybody has experienced this at one point or another; isn’t it a wonderful thing when it happens?

I met Beth Maloney about two years ago when she contacted me after reading my book, “Becoming Whole” about my recovery from invasive breast cancer (after losing my leg to bone cancer). At that time she shared a copy of her own book with me “Saving Sammy” about her son’s incredible odyssey to regain his health. Beth and I found that we had a lot in common and became good friends.

When a well-adjusted, happy child suddenly begs not to be touched, won’t eat certain foods, refuses to bathe or suffers from a personality transformation that could only be described as bizarre, an increasing body of evidence suggests that an infection could be to blame.

The infection is strep, and the condition it appears to trigger in a small number of children is called PANDAS—short for pediatric autoimmune neuropsychiatric disorder.