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Perianal streptococcal cellulitis

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

Causes

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

The skin around the anus may get infected while a child wipes the area after using the toilet. The infection can also result from scratching the area with fingers that have bacteria from the 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 the 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 are rare, but may include:

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 may 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.

Alternative Names

Streptococcal proctitis; Proctitis - streptococcal; Perianal streptococcal dermatitis

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 14.

Shulman ST, Reuter CH. Group A streptococcus. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 210.

Review Date 11/9/2019

Updated 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, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.