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</div><div><span>Perianal streptococcal cellulitis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Perianal streptococcal cellulitis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Perianal streptococcal cellulitis is an infection of the area around the anus and rectum. The infection is caused by streptococcus bacteria.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Perianal streptococcal cellulitis usually occurs in children. It often appears during or after <a test="test" href="./000639.htm">strep throat</a>, nasopharyngitis, or streptococcal skin infection (<a test="test" href="./000860.htm">impetigo</a>).</p><p>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.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Symptoms may include:</p><ul><li>Fever</li><li>Itching, pain, or bleeding with bowel movements</li><li>Redness around the anus</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will examine the child and ask about the symptoms.</p><p>Tests that may be done include:</p><ul><li><a test="test" href="./003759.htm">Rectal swab culture</a></li><li>Skin culture from rectal area</li><li><a test="test" href="./003746.htm">Throat culture</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>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.</p><p>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.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Children usually recover quickly with antibiotic treatment. It is important to contact your provider if your child does not get better soon on antibiotics.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications are rare, but may include:</p><ul><li>Anal scarring, <a test="test" href="./002365.htm">fistula</a>, or <a test="test" href="./001519.htm">abscess</a></li><li>Bleeding, discharge</li><li>Bloodstream or other streptococcal infections (including heart, joint, and bone)</li><li>Kidney disease (acute <a test="test" href="./000484.htm">glomerulonephritis</a>)</li><li>Severe skin and soft tissue infection (<a test="test" href="./001443.htm">necrotizing fasciitis</a>)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your child's provider if your child complains of pain in the rectal area, painful bowel movements, or other symptoms of perianal streptococcal cellulitis.</p><p>If your child is taking antibiotics for this condition and the area of redness gets worse, or the discomfort or fever is increasing, contact your provider immediately.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Careful handwashing may help prevent this and other infections caused by bacteria carried in the nose and throat.</p><p>To prevent the condition from coming back (relapse), be sure your child finishes all the medicine the provider prescribes.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Streptococcal proctitis; Proctitis - streptococcal; Perianal streptococcal dermatitis</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Paller AS, Mancini AJ. Bacterial, mycobacterial, and protozoal infections of the skin. In: Paller AS, Mancini AJ, eds. <em>Paller and Mancini - Hurwitz Clinical Pediatric Dermatology</em>. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 14.</p><p>Shulman ST, Patel AB. Group A streptococcus. In: Kliegman RM, St. Geme JW, Blum NJ, et al, eds. <em>Nelson Textbook of Pediatrics</em>. 22nd ed. Philadelphia, PA: Elsevier; 2025:chap 229.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 12/31/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
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