Perianal strep, also known as perianal streptococcal dermatitis or cellulitis, is a bacterial infection affecting the skin around the anus and rectum. This condition is caused by Group A Streptococcus bacteria, the same type responsible for strep throat. It is important to identify perianal strep because it requires specific antibiotic treatment to resolve the infection and prevent potential complications. While it can occur in adults, it is most frequently observed in children, particularly those between six months and ten years of age.
Recognizing Symptoms
Recognizing the signs of perianal strep is the first step toward seeking appropriate medical attention. A prominent symptom is a bright red, sharply defined rash that appears around the anus. This rash may extend a few centimeters from the anal opening and can sometimes spread to the genitals, such as the vulva or penis. The affected skin often looks moist and can be significantly redder than a typical diaper rash.
Individuals with perianal strep commonly experience discomfort in the anal area. This can manifest as itching, which may be intense, and pain, especially during bowel movements. This pain can sometimes lead to constipation as individuals may try to avoid defecation due to the discomfort. In some cases, blood streaks may be visible in the stool due to skin breakdown or fissures caused by the infection or scratching.
The Testing Procedure
Diagnosing perianal strep involves a medical professional assessing the affected area. The process begins with a physical examination, where the doctor observes the characteristic rash and notes any associated symptoms. To confirm Group A Streptococcus, a swab is taken directly from the infected perianal skin.
The collected sample is then sent to a laboratory for analysis. Two primary diagnostic methods are used: a rapid strep test or a bacterial culture. A rapid strep test provides quick results, often within minutes, by detecting specific antigens. While convenient, rapid tests can sometimes yield false-positive results.
A bacterial culture, on the other hand, involves growing the bacteria from the swab sample in a controlled environment. This method is considered the definitive way to confirm perianal strep, as it directly identifies Group A Streptococcus. Results from a culture usually take 24 to 48 hours to become available.
Interpreting Results and Treatment
Once laboratory tests are complete, the healthcare provider will communicate the results, confirming or ruling out perianal strep. A positive bacterial culture definitively indicates Group A Streptococcus. If positive, antibiotic treatment is necessary to clear the infection.
The standard treatment for perianal strep involves oral antibiotics, typically prescribed for a duration of 10 days. Common antibiotics used include penicillin or amoxicillin. It is important to complete the full course of antibiotics, even if symptoms improve quickly, to ensure the infection is fully eradicated and to prevent recurrence. In addition to oral antibiotics, topical creams or ointments, such as mupirocin, may be prescribed to help soothe the area and aid in healing, though these are generally not sufficient as a standalone treatment. Recovery is usually quick with appropriate antibiotic therapy.