Perianal cellulitis in children caused by group A streptococcus

Abstract

The diagnosis of perianal cellulitis caused by group A streptococcus is often missed because of lack of awareness of this clinical entity. Over an 8-year period 20 children were treated for this condition. Their symptoms had all followed a protracted course because of a failure to identify the underlying pathology. The diagnosis should be suspected when there is perianal cellulitis, often accompanied by an anal fissure or superficial cracking of the skin, which goes on to follow a chronic course. All children responded to penicillin V, but a 3-week course was required in most, and in one-third of the patients a second course was necessary. In light of this experience, co-amoxiclav would be a more appropriate antibiotic.