Patient description: Fernandez is a 41 year man who is a professional soccer player. He came to the clinic with itchy foot. Physical exam revealed localized scaling and maceration between the third and fourth of his right toe. It became inflamed and sore, with mild fissuring. The dorsum and sole of the foot was unaffected. There is no pus or tearing in the affected area. He didn't use ant topical ointment on the lesion and has no positive history for any underlying disease such as DM. He smokes 15 cigarettes per day and drinks a beer per day. His family history is positive for hyperlipidemia in her mother and MI in her father. He is in relation with several partners and use condom during the intercourse. His physical exam and lab studies were normal otherwise. Tinea pedis infection confirmed as his diagnosis by the observation of segmented fungal hyphae during a microscopic KOH wet mount examination.

Clinical trial eligibility criteria: eligible ages (years): 3.0-999.0,  Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) Affected Probands (Children with PANS) will be eligible if they: 1. Are 3 to 14 years of age (initial enrollment must occur prior 2. Have a history of abrupt onset (less than 24-48 hours) of impairing OCD and/or eating restrictions. 3. Are able to travel safely to the regional medical center where the evaluations will be conducted and are able to be examined safely over a period of one or more days. 4. Assent to participate (if they are at least seven years old and have capacity to do so) and have legal guardians who consent to their minor child s participation. 5. Are under the care of a primary physician in their home community. First-degree Relatives will be eligible if they: 1. Are a biologic parent or sibling of an affected proband. 2. Consent (or assent) to undergo study evaluations and to provide blood, microbial and genetic samples. Children with Non-PANS Neuropsychiatric Symptoms may be enrolled if they: 1. Are 3 to 14 years of age (initial enrollment must occur prior to the participant s 15th birthday to permit prospective longitudinal evaluations) 2. Have OCD, tics, anxiety disorders, or other psychiatric symptoms, but do NOT have a history of acute symptom onset. 3. Are willing to participate in medical, psychiatric, and behavioral assessments and to provide bio-specimens including blood, urine, and microbial flora (mouth, oropharynx, and/or stool). 4. Assent to participate (if they are at least seven years old and have capacity to do so) and have legal guardians who consent to their minor child s participation. 5. Are under the care of a primary physician in their home community. Healthy Pediatric Volunteers may be enrolled if they: 1. Are 3 to 14 years of age (initial enrollment must occur prior to the participant s 15th birthday to permit prospective longitudinal evaluations). 2. Are physically healthy and do not have psychiatric symptoms. 3. Are willing to participate in medical, psychiatric, and behavioral assessments and to provide bio-specimens including blood, urine, and microbial flora (mouth, oropharynx, and/or stool). 4. Assent to participate (if they are at least seven years old and have capacity to do so) and have legal guardians who consent to their minor child s participation  Participants will not be eligible if they: 1. Appear to the investigators to be too unstable psychiatrically or medically to participate safely in the protocol. 2. Are unwilling or unable to be evaluated and followed prospectively. 3. Have a parent/guardian who is not willing to participate at a distance through web-based or phone-based data collection