Article

3 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates

  • You can purchase this item in Pay Per ViewPay per View - FAQ : 30,00 € Taxes included to order
    Pages Iconography Videos Other
    3 3 0 0


Archives de pédiatrie
Volume 7, n° 11
pages 1194-1196 (novembre 2000)
Received : 2 August 1999 ;  accepted : 12 July 2000
Anite périanale streptococcique
Perianal streptococcal dermatitis.

A.L.  Souillet 1 ,  F.  Truchot 1 ,  D.  Jullien 1 ,  V.  Dumas 1 ,  M.  Faure 1 ,  D.  Floret 2 ,  A.  Claudy 1
1Clinique dermatologique et vénéréologique, hôpital Édouard-Herriot, place d'Arsonval, 69437 Lyon cedex 03, France 
2service de pédiatrie, hôpital Édouard-Herriot, place d'Arsonval, 69437 Lyon cedex 03, France 

@@#100979@@

L'anite streptococcique de l'enfant est une entité bien définie cliniquement. Cependant mal connue, son diagnostic est souvent porté tardivement, exposant l'enfant aux complications habituelles des infections à streptocoque.

Observation. - Sophia, sept ans, souffrait d'un érythème périanal rouge vif bien limité, douloureux, responsable d'une constipation réflexe. Il existait une extension vulvaire. Cette symptomatologie avait été précédée d'une pharyngite fébrile et s'accompagnait d'un impétigo périlabial récent. Un traitement antifongique local était resté inefficace. Devant ce tableau clinique typique, le diagnostic d'anite streptococcique était évoqué et confirmé par la présence dans les prélèvements locaux de streptocoque bêta-hémolytique du groupe A. Un traitement par ampicilline à la posologie de 50 mg/kg et par jour, pendant dix jours, était instauré et permettait une guérison clinique en 48 heures.

Conclusion. - La reconnaissance de la symptomatologie doit permettre d'évoquer le diagnostic d'anite streptococcique devant tout érythème périanal rouge vif à limites nettes, parfois associé à un oedème cutané, à un suintement séreux ou séro-hématique. La mise en place d'un traitement antibiotique oral adapté permet à la fois une guérison rapide et limite le risque de morbidité secondaire (rhumatisme articulaire aigu, glomérulonéphrite aiguë post-streptococcique).

Mots clés  : dermatite périanale ; streptocoque.

Abstract

Background. - Pediatric perianal streptococcal dermatitis (PSD) is a well-defined clinical entity. However, its highly uniform presentation remains surprisingly unrecognized by many practitioners 33 years after its first description.

Case report. - A seven-year-old girl had a three-week history of perianal and vulva redness with well-defined margins. Functional symptoms associated perirectal tenderness and pain during defecation, which was responsible for constipation. At onset she also presented with a sore throat, which resolved spontaneously, and she had been complaining for a few days about a perioral impetigo. She received mycostatin unsuccessfully for an alleged candidiasis. Positive cultures for group A β-hemolytic streptococci from both perirectal and perioral swabs confirmed the diagnosis of PSD. Therapy with amoxicillin (50 mg/kg/d) was prescribed for ten days. Perianal lesions were cleared by day 2.

Conclusion. - Since PSD can masquerade as candidiasis, psoriasis, seborrheic dermatitis, inflammatory bowel disease or even sexual abuse, it remains an underdiagnosed entity. This situation leads to delayed diagnosis and treatment which in turn might increase the frequency of secondary complications related to streptococcal infections (i.e., post-streptococcal acute nephritis and rheumatism, guttate psoriasis, etc.).

Mots clés  : perianal dermatitis ; anus ; proctitis ; streptococcal infections ; cellulitis ; child.




© 2000  Éditions scientifiques et médicales Elsevier SAS. All Rights Reserved.

EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline
You can move this window by clicking on the headline