Important Note

Diagnosis of perianal cellulitis

Screening patients and health care workers for Streptococcus pyogenes for the purpose of investigating possible nosocomial transmission

Streptococcus pyogenes (group A streptococcus) is a common cause of pharyngitis and skin and soft tissue infection. In children, S pyogenes can cause perianal infection. The classic presentation is a well-demarcated rash around the anus with itching, rectal pain, and, occasionally, blood-streaked stools. Untreated, painful defecation, toilet avoidance, and constipation may persist for months, until effective treatment is administered. Anal fissures may ensue. A swab of the affected area may be submitted for S pyogenes culture to confirm the diagnosis.

Health care workers may transmit S pyogenes to their patients (eg, in the postsurgical setting) leading to outbreaks of invasive disease. Screening of health care workers or other patients for S pyogenes may be requested by Infection Prevention and Control as part of an investigation of a potential nosocomial case (or cases).