Affiliations: Department of General Surgery, General Hospital of
Kefalonia, Kefalonia, Greece
Note: [] Correspondence: Saravakos Panagiotis, Department of General
Surgery, General Hospital of Kefalonia, Soudias Street, Argostoli, Kefalonia,
GR-28100, Greece. E-mail: psaravakos@yahoo.com
Abstract: Bacterial perianal dermatitis is a childhood disorder, most commonly
caused by the beta-hemolytic group A streptococcus. Despite being
well-recognized in the literature, this condition is often not recognized by
healthcare practitioners, leading to a delay in the proper diagnosis and
treatment. An 8-year-old boy presented with a three-week history of perianal
itching, constipation and blood-streaked stools. Clinical examination revealed
a bright red, sharply demarcated rash that extended approximately 3 cm
circumferentially around the anus. Positive cultures for Enterococcus faecalis
from the perianal area and the stools confirmed the diagnosis of perianal
dermatitis caused by an uncommon microorganism. Therapy with systematic oral
cefuroxime and topical mupirocin cream led to a resolution of the symptoms and
the itchy rash by day 4. 2 weeks after the onset of symptoms in the patient,
his 10-year-old brother developed perianal itching and mucous discharge. Stool
cultures again identified E. faecalis and the same treatment methods were
applied, resulting in rapid resolution of the symptoms. Perianal dermatitis
should be included in the differential diagnosis when a child aged from 6
months to 10 years old complains of perianal symptomatology. The differential
diagnosis is wide and includes candidiasis, psoriasis, inflammatory bowel
disease, diaper dermatitis, parasite infections and sexual abuse. The diagnosis
is confirmed with culture swabs of the affected area and treatment should be
guided based on the culture and antibiotic sensitivity testing.
