As the streptococci continue to colonize, the formation of a biofilm may arise and its protective properties may make it more difficult to treat the infection with antibiotics.In cases of perianal cellulitis infections that are not treated properly, group A beta-hemolytic streptococci may cross into the bloodstream through the epithelium of the perianal area to cause serious infections such as necrotizing fasciitis or toxic shock syndrome. The group A beta-hemolytic streptococci bacteria that enter the bloodstream are able to cause serious infections by overpowering natural immune responses and allowing bacteria to rapidly multiply to cause harm to the body. Treatment
After the diagnosis of perianal streptococcal dermatitis has been confirmed, the most successful treatment regimens utilize a combination of topical and systemic antibiotics. Oral antibiotics are the recommended first-line treatment for perianal streptococcal dermatitis. Perianal streptococcal dermatitis does not resolve on its own. The treatment of choice for oral antibiotics include "penicillin V, azithromycin, clarithromycin, clindamycin, erythromycin, penicillinase-resistant penicillin, or cephalosporins." Oral antibiotics work best in combination with a topical antibiotic such as mupirocin, or an antiseptic such as chlorhexidine. Due to the affect that perianal streptococcal dermatitis has on the deeper layers of the skin, topical antimicrobial therapy alone appears to be poorly effective. Treatment duration ranges from 14 to 21 days and treatment success is determined by clinical examination and post-treatment swabbing of the affected area to confirm that the infection is no longer present. Prevention & Recurrence
There is little data that currently exists on the prevention of perianal cellulitis.
Perianal cellulitis, also known as perianitis or perianal streptococcal dermatitis, is a bacterial infection affecting the lower layers of the skin (cellulitis) around the anus. It presents as bright redness in the skin and can be accompanied by pain, difficulty defecating, itching, and bleeding. This disease is considered a complicated skin and soft tissue infection (cSSTI) because of the involvement of the deeper soft tissues.Perianal cellulitis is most commonly caused by group A beta-hemolytic streptococcus bacteria (Streptococcus pyogenes), which resides normally ("in small numbers") in the human throat and on the human skin. Other less common causes may include infection with group B beta-hemolytic streptococci (Streptococcus agalactiae), a bacteria found in the human vagina of some, or Staphylococcus aureus, a common component of the bacterial community in the human nose and/or skin.Perianal cellulitis occurs mainly in male children between six months and 10 years of age, however, there are documented cases of perianal cellulitis in adults as well. Oral antibiotics are the first line treatment for perianal cellulitis and may be used in combination with topical antibiotics. Since the infection occurs within the deeper layers of skin, using a topical treatment by itself may not be effective. In about 20% of cases, recurrence of perianal streptococcal dermatitis infection occurs within 3.5 months. Routine hygiene practices should also be encouraged in children and adults in order to reduce the risk of recurrent infection. Signs and symptoms
Perianal cellulitis manifests as multiple symptoms that are inconsistent with a systemic disease.