Perianal streptococcal cellulitis

Definition

Streptococcal proctitis is an inflammation of the anus and rectum caused by streptococcus bacteria.

Alternative Names

Causes

Streptococcal proctitis is usually a disease of children and often occurs in conjunction with "strep throat" (streptococcal pharyngitis) or nasopharyngitis. Children infect the skin around the anus while cleaning the area after using the toilet or by scratching with hands contaminated by secretions from their mouth or nose.

Symptoms include an expanding area of redness around the anus, complaints of itching and pain and, on occasion, pain with bowel movements. They may also have a fever.

Symptoms

• History of present or recent "strep throat" or other streptococcal infection, such as a streptococcal skin infection (impetigo)
• Redness around the anus
• Complaints of perianal discomfort
• Discomfort or bleeding with bowel movements

Exams and Tests

• Throat culture (positive for beta hemolytic streptococcus, group A)
• Culture, rectal swab (positive for beta hemolytic streptococcus, group A)

Treatment

The infection is treated with antibiotics for about 10 days, depending on how well and quickly it appears to be working. Penicillin is the most frequently used antibiotic in children who are not allergic. Topical (applied directly to the skin) treatment with mupirocin may be used along with other antibiotics, but should not be the only treatment.

Outlook (Prognosis)

Rapid recovery is expected with antibiotic treatment. It is important to contact your health care provider if recovery does not occur rapidly on antibiotics.

Possible Complications

• Acute glomerulonephritis (kidney disease)
• Necrotizing fasciitis (severe skin and soft tissue infection)
• Bleeding, discharge
• Bloodstream or other streptococcal infections (including heart, joint, bone, and others)
• Anal scarring, fistula, or abscess formation

When to Contact a Medical Professional

Call your health care provider if your child complains of pain in the rectal area, painful bowel movements, or other symptoms of streptococcal proctitis.

If your child is receiving antibiotics for streptococcal proctitis, and the area of redness is expanding, or the discomfort or fever are increasing, then call your health care provider immediately. Your health care provider can help answer other questions that you might have about streptococcal proctitis.

Prevention

Completion of a full course of antibiotic treatment for pharyngeal and other infections with streptococcus bacteria is effective in eliminating the bacteria from the affected site. Careful handwashing is helpful in preventing this and other infections that result from bacteria carried in the nose and throat.

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