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A previously healthy 3-year-old boy presented with rectal pain and refusal to sit and defecate over the past 24 h. He had no fever. The perianal region showed a painful circumferential bright erythema with well-demarcated margins (diameter 4 cm) covered with light exudate (Fig. 1). An anal fissure was noted. He had chronic obstipation. There were no close contacts with tonsillitis or impetigo. The rapid antigen detection test for group A Streptococcus (GAS) of the perianal lesion showed a positive result (Healgen GAS Rapid Test – Cassette). The boy was treated with oral amoxicillin 50 mg/kg/day for 10 days, resulting in rapid clinical improvement with no relapse.
Figure 1Perianal bright circumferential erythema covered with light exudate.
Perianal streptococcal dermatitis is a superficial skin infection generally caused by GAS but rarely reported. The incidence is unknown, although boys aged between 6 months and 10 years are more commonly affected.
The rapid antigen detection test of a perianal lesion has been used to confirm the causative agent. Although approved for only pharyngeal samples, these tests have demonstrated a good correlation with cultural examination,
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