Perianal streptococcal cellulitis
Streptococcal proctitis; Proctitis - streptococcal; Perianal streptococcal dermatitis
Perianal streptococcal cellulitis is an infection of the anus and rectum caused by Streptococcus bacteria.
Causes
Perianal streptococcal cellulitis usually occurs in children, often during or after strep throat , nasopharyngitis, or streptococcal skin infection ( impetigo ).
Strep throat
Strep throat is a disease that causes a sore throat (pharyngitis). It is an infection with a germ called group A streptococcus bacteria.
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:
- Rectal swab culture
- Skin culture from rectal area
-
Throat culture
Throat culture
A throat swab culture is a laboratory test that is done to identify germs that may cause infection in the throat. It is most often used to diagnose ...
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
Fistula
A fistula is an abnormal connection between 2 body parts, such as an organ or blood vessel and another structure. Fistulas are usually the result of...
Abscess
An anorectal abscess is a collection of pus in the area of the anus and rectum.
- Bleeding, discharge
- Bloodstream or other streptococcal infections (including heart, joint, and bone)
-
Kidney disease (acute
glomerulonephritis
)
Glomerulonephritis
Glomerulonephritis is a type of kidney disease in which the part of your kidneys that helps filter waste and fluids from the blood is damaged....
-
Severe skin and soft tissue infection (
necrotizing fasciitis
)
Necrotizing fasciitis
Necrotizing soft tissue infection is a rare but very severe type of bacterial infection. It can destroy the muscles, skin, and underlying tissue. T...
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.