Perianal cellulitis | |
---|---|
Other names | Perianitis, Perianal streptococcal dermatitis, Perianal dermatitis,[1] Streptococcal anitis,[1] Streptococcal perianitis[1] |
Specialty | Dermatology |
Symptoms | Redness, swelling, itching, pain |
Duration | Treatment ranges from 14 to 21 days |
Causes | Group A Streptococci (Streptococcus pyogenes) (most common) Group B Streptococci (Streptococcus agalactiae) |
Diagnostic method | Bacterial culture |
Differential diagnosis | Candidiasis, irritant diaper dermatitis, pinworm infestation, chronic inflammatory bowel disease, seborrheic dermatitis, or even sexual abuse. |
Perianal cellulitis, also known as perianitis or perianal streptococcal dermatitis, is a bacterial infection affecting the lower layers of the skin (cellulitis) around the anus.[1][2][3] It presents as bright redness in the skin and can be accompanied by pain, difficulty defecating, itching, and bleeding.[4][1] This disease is considered a complicated skin and soft tissue infection (cSSTI) because of the involvement of the deeper soft tissues.[5]
Perianal cellulitis is most commonly caused by group A beta-hemolytic streptococcus bacteria (Streptococcus pyogenes), which resides normally ("in small numbers") in the human throat and on the human skin.[6][7] Other less common causes may include infection with group B beta-hemolytic streptococci (Streptococcus agalactiae), a bacterium found in the human vagina of some, or Staphylococcus aureus, a common component of the bacterial community in the human nose and/or skin.[8][7]
Perianal cellulitis occurs mainly in male children between six months and 10 years of age, however, there are documented cases of perianal cellulitis in adults as well.[8] Oral antibiotics are the first line treatment for perianal cellulitis and may be used in combination with topical antibiotics.[1] Since the infection occurs within the deeper layers of skin, using a topical treatment by itself may not be effective.[1] In about 20% of cases, recurrence of perianal streptococcal dermatitis infection occurs within 3.5 months.[1] Routine hygiene practices should also be encouraged in children and adults in order to reduce the risk of recurrent infection.[1]
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