Definition of Proctitis - streptococcal:

Streptococcal proctitis is an inflammation of the anus and rectum caused by Streptococcus bacteria.

Causes, incidence, and risk factors:

Streptococcal proctitis usually occurs in children, often with or after "strep throat" (streptococcal pharyngitis), nasopharyngitis, or streptococcal skin infection (impetigo).

Children infect the skin around the anus while cleaning the area after using the toilet or by scratching with hands contaminated by secretions from their mouth or nose.

Symptoms:

• Itching, pain, or bleeding with bowel movements
• Redness around the anus
• Sometimes fever

Signs and tests:

• Rectal swab culture
• Throat culture

Treatment:

The infection is treated with antibiotics for about 10 days, depending on how well and quickly it appears to be working. Penicillin is the most often used antibiotic in children who are not allergic to it.

Mupirocin can be applied directly to the skin (topical). It can be used along with other antibiotics, but should not be the only treatment.

Expectations (prognosis):

Children usually recover quickly with antibiotic treatment. It is important to contact your health care provider if your child does not get better soon on antibiotics.

Complications:

• Anal scarring, fistula, or abscess
• Bleeding, discharge
• Bloodstream or other streptococcal infections (including heart, joint, and bone)
• Kidney disease (acute glomerulonephritis)
• Severe skin and soft tissue infection (necrotizing fasciitis)

Calling your health care provider:

Call your health care provider if your child complains of pain in the rectal area, painful bowel movements, or other symptoms of streptococcal proctitis.

If your child is taking antibiotics for streptococcal proctitis and the area of redness is expanding or the discomfort or fever are increasing, call your health care provider immediately. Your health care provider can help answer other questions that you might have about streptococcal proctitis.

Prevention:

Take a full course of antibiotics to eliminate the bacteria from the affected site. Careful handwashing can help prevent this and other infections caused by bacteria carried in the nose and throat.