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Perianal streptococcal cellulitis

Definition

Perianal streptococcal cellulitis is an infection of the anus and rectum caused by Streptococcus bacteria.

Alternative Names

Streptococcal proctitis; Proctitis - streptococcal; Perianal streptococcal dermatitis

Causes

Perianal streptococcal cellulitis usually occurs in children, often during or after strep throat, nasopharyngitis, or streptococcal skin infection (impetigo).

Children may infect the skin around the anus while cleaning the area after using the toilet or by scratching with hands that have bacteria from their mouth or nose.

Symptoms

Symptoms may include:

  • Fever
  • Itching, pain, or bleeding with bowel movements
  • Redness around the anus

Exams and Tests

The health care provider will examine the child and ask about the symptoms.

Tests that may be done include:

Treatment

The infection is treated with antibiotics for about 10 days, depending on how well and quickly they are working. Penicillin is the most often used antibiotic in children.

Topical medicine can be applied to skin and is commonly used with other antibiotics, but it should not be the only treatment. Mupirocin is a common topical medicine used for this condition.

Outlook (Prognosis)

Children usually recover quickly with antibiotic treatment. It is important to contact your provider if your child does not get better soon on antibiotics.

Possible Complications

Complications that may result include:

  • Anal scarring, fistula, or abscess
  • Bleeding, discharge
  • Bloodstream or other streptococcal infections (including heart, joint, and bone)
  • Kidney disease (acute glomerulonephritis)
  • Severe skin and soft tissue infection (necrotizing fasciitis)

When to Contact a Medical Professional

Call your child's provider if your child complains of pain in the rectal area, painful bowel movements, or other symptoms of perianal streptococcal cellulitis.

If your child is taking antibiotics for this condition and the area of redness gets worse, or the discomfort or fever is increasing, call your provider immediately.

Prevention

Careful handwashing can help prevent this and other infections caused by bacteria carried in the nose and throat.

To prevent the condition from coming back, be sure your child finishes all the medicine the provider prescribes.

References

Paller AS, Mancini AJ. Bacterial, mycobacterial, and protozoal infections of the skin. In: Paller AS, Mancini AJ, eds. Hurwitz Clinical Pediatric Dermatology. 5th ed. Philadelphia, PA: Elsevier; 2016:chap 22.

Shulman ST. Group A streptococcus. In: Kliegman RM, Stanton BF, St Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 183.

Review Date:12/10/2015
Reviewed By:Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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