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Perianal streptococcal cellulitis
Definition
Perianal streptococcal cellulitis is an inflammation of the anus and rectum caused by Streptococcus bacteria.
Alternative Names
Streptococcal proctitis; Proctitis - streptococcal
Causes
Perianal streptococcal cellulitis usually occurs in children, often with 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
- Fever
- Itching, pain, or bleeding with bowel movements
- Redness around the anus
Exams and Tests
- Rectal swab culture
- Skin culture from rectal area
- Throat culture
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 often used antibiotic in children who are not allergic to it.
Mupirocin can be applied directly to the skin (topical). It can be used along with other antibiotics, but should not be the only treatment.
Outlook (Prognosis)
Children usually recover quickly with antibiotic treatment. It is important to contact your health care provider if your child does not get better soon on antibiotics.
Possible Complications
- 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 health care 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 are increasing, call your health care provider immediately.
Prevention
Take a full course of antibiotics to eliminate the bacteria from the affected site. Careful handwashing can help prevent this and other infections caused by bacteria carried in the nose and throat.
References
Gerber MA. Group A streptococcus.In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 176.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
