
Perianal infection is most commonly caused by streptococcus and staphylococcus bacterial strains. Perianal infection, also called perianal streptococcal dermatitis, is a bright red, sharply demarcated rash that is caused by group A beta-hemolytic streptococci. Common symptoms of perianal infection include perianal rash, rectal pain & itching, blood or pus in stools, etc. Perianal infections most commonly occur in children between 6 months to 10 years of age. Poor hygiene is the major cause of perianal infections in children. Cases of perianal infection in adults are also reported, however, the incidence is rare. Initial observations show moist marinated erythema extended approximately 2-4 cm around the anus. Perianal infections may be accompanied by inflammation of the vulva & vagina in girls or end of the penis in boys. Most children diagnosed with perianal infection have positive cultures for group A beta-hemolytic streptococcal infections (GABHS). Common treatment options include topical antifungal agents such as topical amoxicillin, mupirocin, or penicillin. In severe cases, oral antibiotics are recommended. Oral antibiotic treatment shows dramatic improvement within 24 hours. Prolonged antibiotic treatment for 7-14 days is prescribed to increase the cure rate. Other antibiotics prescribed for the treatment of perianal infection include erythromycin, azithromycin, and clarithromycin, among others. However, in adults, perianal infections are not easily treated with oral antibiotics, and they require sufficiently long courses. According to a study conducted by The Association of Coloproctology of Great Britain and Ireland, only 42% adult patients with perianal infections were cured after the first course of antibiotics. In adults, additional anorectal or dermatological diseases may develop, which extend the course of treatment.