Yes, and this overlap is discussed with increasing frequency in PANS and PANDAS clinical conversations. Lyme disease can affect the central nervous system in some children, producing psychiatric and behavioral symptoms that overlap with PANS and PANDAS — including mood changes, anxiety, and OCD-like behaviors. Tick-borne co-infections such as Bartonella and Babesia are also discussed as potential contributing factors in some cases. Standard Lyme testing has well-documented limitations, particularly early in infection, and a negative test does not definitively rule it out. This is an area where providers genuinely hold different views on testing and treatment, which is one reason seeking a provider familiar with both conditions is important if this overlap is a concern.