These newborn cases of infection often manifest as sepsis, pneumonia, and meningitis, among other presentations.Based on cases studied of children with perianal streptococcal dermatitis, there has been a pattern of perianal infection occurring after being diagnosed with previous streptococcal infections (i.e. "strep throat"). It is believed that bacteria from these infections may be introduced to the skin of the perianal region after touching the nose or mouth and then proceeding to use the toilet or touching the area for any other reason.While perianal streptococcal dermatitis is a treatable condition, there are serious consequences that may arise if left undiagnosed and/or untreated in patients with an infection. Failure to properly diagnose and treat perianal streptococcal dermatitis may lead to more serious infections that could result in injury or death. Mechanism
Upon the initial exposure of Streptococcus pyogenes (group A beta-hemolytic streptocci) bacteria to the skin surrounding the perianal region, the bacteria adheres to the skins surface with filaments on its cell wall surface called adhesins. An adhesin found in group A beta-hemolytic streptococci of particular importance is called the M protein, which utilizes complex mechanisms to recognize various receptors on human cell types for attachment. After attachment, colonization of Streptococcus pyogenes occurs and the bacteria release many toxins that are responsible for the manifestation of symptoms of perianal cellulitis such as inflammation, fever, and itching. Secretion of hyaluronidase, also known as "spreading factor", encourages the Streptococcus pyogenes bacterium to spread more easily throughout the lower layers of skin tissue (subcutaneous tissue).
Epithelial basement membrane dystrophy (EBMD) is a disorder of the eye that can cause pain and dryness. It is sometimes included in the group of corneal dystrophies. It diverges from the formal definition of corneal dystrophy since it is non-familial in most cases. It also has a fluctuating course, while for a typical corneal dystrophy the course is progressive. When it is considered part of this group, it is the most common type of corneal dystrophy. Signs and symptoms
Patients may complain of severe problems with dry eyes, or with visual obscurations. It can also be asymptomatic, and only discovered because of subtle lines and marks seen during an eye exam.EBMD is a bilateral anterior corneal dystrophy characterized by grayish epithelial fingerprint lines, geographic map-like lines, and dots (or microcysts) on slit-lamp examination. Findings are variable and can change with time. While the disorder is usually asymptomatic, up to 10% of patients may have recurrent corneal erosions, usually beginning after age 30; conversely, 50% of patients presenting with idiopathic recurrent erosions have evidence of this dystrophy. Pathophysiology
In some families autosomal dominant inheritance and point mutations in the TGFBI gene encoding keratoepithelin have been identified, but according to the International Committee for Classification of Corneal Diseases (IC3D) the available data still does not merit a confident inclusion of EBMD in the group of corneal dystrophies.