Perianal Streptococcal Infection

Condition

An infectious condition of the skin around the anus in preschool and school-age children, caused by Group A beta-haemolytic streptococcus. Presents as a persistent, itchy, tender, erythematous perianal eruption extending from the anal verge. May be accompanied by fissures, bleeding, discharge, constipation, and pain with defecation. May also involve inflammation of the vulva and vagina in girls, or the end of the penis in boys.

Diagnosis

A perianal swab for bacterial culture confirms the diagnosis.

Management

Perianal infections treated with penicillin recur at a high rate; clinical trials show efficacy for oral cephalosporins.

• Cefalexin 1g twice daily for 5 days, or
• Clindamycin 450mg three times daily for 5 days, or
• Trimethoprim/sulfamethoxazole 160/800mg twice daily for 5 days.