Yes — and this distinction matters for families who have been told their child doesn't have PANDAS because strep wasn't found. PANDAS is specifically defined by its connection to Group A strep. PANS is the broader category, and it does not require a strep trigger. Infections associated with PANS onset include Mycoplasma pneumoniae, influenza, sinusitis, Lyme disease, varicella, and other respiratory infections. In some children, no specific trigger is ever clearly identified even with thorough evaluation. A child who tests negative for strep may still have PANS triggered by a different organism — which is why providers with PANS experience look at the full range of potential triggers, not strep alone.