Published 5 May 2009, doi:10.1136/bmj.b1517
Cite this as: BMJ 2009;338:b1517

Practice

Easily Missed?

Streptococcal perianal infection in children

Richard Lehman, general practitioner1, Sarah Pinder, general practitioner 1

1 Hightown Surgery, Banbury OX16 9DB

Correspondence to: R Lehman richard.lehman@nhs.net

The first 150 words of the full text of this article appear below.


A 3 year old child is brought by her mother, who says that her daughter has had an itchy bottom and pain on opening her bowels most days for the past two weeks. On examination she has an erythematous and excoriated anus with multiple anal fissures. As these symptoms and findings in a preschool child are highly suggestive of streptococcal proctitis, you undertake a perianal swab, which shows a pure growth of group A streptococcus.


Streptococcal perianal infection in children is caused by group A Streptococcus pyogenes and is usually confined to the immediate perianal area, though it can spread to the perineum and occasionally the genitalia.1 2

The incidence of perianal infection caused by group A S pyogenes is not known, but since the first case descriptions in 19663 it has been reported in children from around the world. In a US general paediatric practice, perianal streptococcal disease was detected . . . [Full text of this article]


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