Abstract
Amaç: Bu çalışma, perianal enfeksiyöz dermatit (PED) tanısı alan pediatrik hastaların klinik özelliklerini, mikrobiyolojik bulgularını ve tedavi sonuçlarını değerlendirmeyi; ayrıca bu hastalığın klinik farkındalığını artırarak yanlış tanı oranını azaltmayı amaçlamaktadır.
Gereç ve Yöntem: Bu çalışmada, pediatrik enfeksiyon hastalıkları kliniğinde 0–18 yaş arası PED tanısı alan hastalar retrospektif olarak incelendi. Hastaların demografik özellikleri, klinik bulguları ve mikrobiyolojik kültür sonuçları değerlendirildi. Tanı, karakteristik klinik bulgular ve perianal lezyonlardan elde edilen pozitif kültür sonuçlarına dayanarak konuldu. Çalışmanın amacı, pediatrik perianal dermatitin klinik özelliklerini ortaya koymak ve bu konuda klinisyenler arasındaki farkındalığı artırmaktır.
Bulgular: Çalışmaya dahil edilen toplam dokuz hastaya (ortalama yaş: 5,1 yıl; 8 erkek, 1 kız) PED tanısı konuldu. En sık gözlenen semptomlar anal kaşıntı ve ağrılı dışkılama idi. Fizik muayenede tüm hastalarda belirgin sınırlara sahip perianal eritem tespit edildi. Mikrobiyolojik incelemelerde, 7 hastadan Streptococcus pyogenes, 1 hastadan Streptococcus agalactiae ve 1 hastadan hem S. pyogenes hem de Staphylococcus aureus izole edildi. Tüm hastalara oral amoksisilin tedavisi uygulandı ve tamamında komplikasyon gelişmeksizin tam iyileşme sağlandı.
Sonuç: PED, pediatrik pratikte sıklıkla yanlış tanı almakta ve bu durum tedavinin gecikmesine yol açmaktadır. Bu çalışma, perianal eritem ile başvuran pediatrik hastalarda PED'in doğru şekilde tanınmasının önemini vurgulamaktadır. Zamanında ve uygun şekilde tanı konulduğunda gereksiz müdahaleler ve olası komplikasyonlar önlenebilmektedir.
References
- 1. Nibhanipudi KV. Perianal streptococcal infection. Emerg Med J 2016; 48(1): 32-4.
- 2. Block SL. Perianal dermatitis: much more than just a diaper rash. Pediatr Ann 2013; 42(1): 12-4.
- 3. Diiorio DA, Humphrey SR. Cutaneous bacterial infections. In: Kleigman RT, ST Geme III JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, Behrman RE, editors. Nelson Textbook of Pediatrics. 21 th ed. Philadelphia: Elsevier; 2020. p. 3549-59.
- 4. Lehman R, Pinder S. Streptococcal perianal infection in children. BMJ 2009; 338:b1517.
- 5. Olson D, Edmonson MB. Outcomes in children treated for perineal group A beta-hemolytic streptococcal dermatitis. Pediatr Infect Dis J 2011; 30(11):933–6.
- 6. Serban ED. Perianal infectious dermatitis: an underdiagnosed, unremitting and stubborn condition. World J Clin Pediatr 2018; 7(4):89-104.
- 7. Kahlke V, Jongen J, Peleikis HG, Herbst RA. Perianal streptococcal dermatitis in adults: its association with pruritic anorectal diseases is mainly caused by group B Streptococci. Colorectal Dis 2013; 15(5):602-7.
- 8. Brilliant LC. Perianal streptococcal dermatitis. Am Fam Physician 2000; 61(2):391-7
- 9. Krol AL. Perianal streptococcal dermatitis. Pediatr Dermatol 1990; 7(2):97–100.
- 10. Teillac-Hamel D, de Prost Y. Perianal streptococcal dermatitis in children. Eur J Dermatol 1992;2: 71–4.
- 11. Jongen J, Eberstein A, Peleikis HG, Kahlke V, Herbst RA. Perianal streptococcal dermatitis: an important differential diagnosis in pediatric patients. Dis Colon Rectum 2008; 51(5):584–7.
- 12. Pennycook KM, McCready TA. Perianal streptococcal dermatitis [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 Jun 26; cited 2025 Jun 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537086/.
- 13. Polat M, Özpinar Ş, Holoğlu MC, Ünal NA, Şahin EA, Demirdağ TB, Tapisiz A. Perianal Streptococcal Dermatitis Complicated by Bacteremia: Report of Two Cases With Unusual Presentations. Pediatr Infect Dis J 2025; 44:e144-e14.
Abstract
Aims: This study aims to evaluate the clinical characteristics, microbiological findings, and treatment outcomes of pediatric patients diagnosed with perianal infectious dermatitis (PID) in order to increase clinical awareness and reduce misdiagnosis in routine pediatric practice.
Material and Method: We retrospectively reviewed pediatric patients aged 0-18 years diagnosed with PID at a pediatric infectious diseases clinic. Demographic data, clinical symptoms, and culture results were analyzed. Diagnosis was based on clinical presentation and positive cultures from perianal lesions. This study aims to describe the clinical features of pediatric PID and increase awareness among clinicians.
Results: Nine pediatric patients (mean age: 5.1 years, 8 boys, 1 girl) were diagnosed with PID. The most common symptoms were anal itching and painful defecation. Physical examination showed well-demarcated erythema in the perianal region. Streptococcus pyogenes was isolated in 7 patients, Streptococcus agalactiae in 1 patient, and both S. pyogenes and Staphylococcus aureus in 1 patient. All patients were treated with oral amoxicillin, leading to full recovery without complications.
Conclusion: PID is often misdiagnosed, delaying appropriate treatment. This study highlights the importance of recognizing PID in pediatric patients presenting with perianal erythema, which can prevent unnecessary interventions and complications when appropriately diagnosed and treated.
References
- 1. Nibhanipudi KV. Perianal streptococcal infection. Emerg Med J 2016; 48(1): 32-4.
- 2. Block SL. Perianal dermatitis: much more than just a diaper rash. Pediatr Ann 2013; 42(1): 12-4.
- 3. Diiorio DA, Humphrey SR. Cutaneous bacterial infections. In: Kleigman RT, ST Geme III JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, Behrman RE, editors. Nelson Textbook of Pediatrics. 21 th ed. Philadelphia: Elsevier; 2020. p. 3549-59.
- 4. Lehman R, Pinder S. Streptococcal perianal infection in children. BMJ 2009; 338:b1517.
- 5. Olson D, Edmonson MB. Outcomes in children treated for perineal group A beta-hemolytic streptococcal dermatitis. Pediatr Infect Dis J 2011; 30(11):933–6.
- 6. Serban ED. Perianal infectious dermatitis: an underdiagnosed, unremitting and stubborn condition. World J Clin Pediatr 2018; 7(4):89-104.
- 7. Kahlke V, Jongen J, Peleikis HG, Herbst RA. Perianal streptococcal dermatitis in adults: its association with pruritic anorectal diseases is mainly caused by group B Streptococci. Colorectal Dis 2013; 15(5):602-7.
- 8. Brilliant LC. Perianal streptococcal dermatitis. Am Fam Physician 2000; 61(2):391-7
- 9. Krol AL. Perianal streptococcal dermatitis. Pediatr Dermatol 1990; 7(2):97–100.
- 10. Teillac-Hamel D, de Prost Y. Perianal streptococcal dermatitis in children. Eur J Dermatol 1992;2: 71–4.
- 11. Jongen J, Eberstein A, Peleikis HG, Kahlke V, Herbst RA. Perianal streptococcal dermatitis: an important differential diagnosis in pediatric patients. Dis Colon Rectum 2008; 51(5):584–7.
- 12. Pennycook KM, McCready TA. Perianal streptococcal dermatitis [Internet]. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025 Jan– [updated 2023 Jun 26; cited 2025 Jun 25]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537086/.
- 13. Polat M, Özpinar Ş, Holoğlu MC, Ünal NA, Şahin EA, Demirdağ TB, Tapisiz A. Perianal Streptococcal Dermatitis Complicated by Bacteremia: Report of Two Cases With Unusual Presentations. Pediatr Infect Dis J 2025; 44:e144-e14.
Details
| Primary Language | English |
|---|---|
| Subjects | Pediatric Infectious Diseases |
| Journal Section | Original Research |
| Authors | |
| Publication Date | July 31, 2025 |
| Submission Date | June 3, 2025 |
| Acceptance Date | July 3, 2025 |
| Published in Issue | Year 2025 Volume: 15 Issue: 4 |
