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[Group A streptococcal perineal infection in children]

M Koskas1, C Levy2, O Romain1

  • 1ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.

Archives De Pediatrie : Organe Officiel De La Societe Francaise De Pediatrie
|December 3, 2014
PubMed

Insights

Group A Streptococcus (GAS) causes pediatric perineal infections that require prompt diagnosis and treatment, as symptoms persist without intervention and penicillin treatment often fails. Early diagnosis via rapid antigen testing improves management outcomes.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Dermatology

Context:

  • Perineal diseases in children are frequently caused by Group A Streptococcus (GAS).
  • Untreated GAS infections can lead to prolonged symptoms and frequent treatment failures or recurrences, particularly with penicillin.
  • A significant number of pediatric perineal infections involve perianal sites.

Purpose:

  • To analyze the clinical characteristics of pediatric perineal infections caused by GAS.
  • To evaluate the diagnostic performance of the GAS-rapid antigen test compared to GAS culture.
  • To understand the natural course and treatment challenges of these infections.

Summary:

  • A study of 165 pediatric perineal infections (balanitis, vulvo-vaginal, and perianal) from 2009-2014 identified GAS as a common etiology.
  • GAS perianal infections were significantly associated with painful defecation, anal fissures, and blood in stools.
  • The GAS-rapid antigen test demonstrated high sensitivity (97%) and negative predictive value (97%) but moderate specificity (76%) and positive predictive value (71%) compared to culture.

Impact:

  • Highlights the importance of timely diagnosis and effective treatment for pediatric GAS perineal infections.
  • Provides data on the clinical presentation of GAS perianal infections in children.
  • Informs clinical practice regarding the utility and limitations of rapid antigen detection for GAS in pediatric perineal infections.

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