Anyone have love one with Pandas strep infection? How do I get doctors to treat for this?

The way I understand it PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococal infections)is acquired in childhood to early teen years. It is caused by very unusual autoimmune reaction to an untreated or under treated strep infection. I have a teenage granddaughter who suffered from extreme moods swings (including cutting herself), severe ADHD and OCD after having a sore throat when she was 11 years old. She was put on an anti-depressant and went to counseling for 3 years. At 15 years old, she had another flare-up of strep and two weeks later went into a psychotic depression and stabbed herself in the stomach. Her ASO titer was off the charts. She was then diagnosed in retrospect of having had PANDA since she was about 8 years old, the first time she had strep. At that time she started ADHD behavior and some OCD. After a week of IV antibiotics and being put in isolation in the infectious disease floor, and 4 more months of oral antibiotics, she is now a normal teenager 17 year old with no severe mood swings or self-mutilation tendencies.

This is the typical run of PANDA. In a nursing home situation, I would suspect that it is not PANDA, but a UTI that might be causing behavior changes. Or it could be any other common infection, pain, or just the dementia affecting the frontal lobe. I would be highly suspect of a diagnosis of PANDA by the nurses without a history of severe strep infections and a high ASO titer.