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Diagnosis of perianal cellulitis
Screening patients and health care workers for Streptococcus pyogenes for the purpose of investigating possible nosocomial transmission
When this test is ordered, the reflex tests may be performed at an additional charge.
Streptococcus pyogenes (group A streptococcus) is a common cause of pharyngitis and skin and soft tissue infection. In children, S pyogenes can cause perianal infection. The classic presentation is a well-demarcated rash around the anus with itching, rectal pain, and, occasionally, blood-streaked stools. Untreated, painful defecation, toilet avoidance, and constipation may persist for months, until effective treatment is administered. Anal fissures may ensue. A swab of the affected area may be submitted for S pyogenes culture to confirm the diagnosis.
Health care workers may transmit S pyogenes to their patients (eg, in the postsurgical setting) leading to outbreaks of invasive disease. Screening of health care workers or other patients for S pyogenes may be requested by Infection Prevention and Control as part of an investigation of a potential nosocomial case (or cases). Isolates may be typed to assess strain relatedness.
Negative
Positive cultures are reported out as Streptococcus pyogenes.
No significant cautionary statements
1. Spellerberg B, Brandt C, Sendi P: Streptococcus. In Manual of Clinical Microbiology. 12th edition. Edited by KC Carroll, MA Pfaller. Washington DC, ASM Press 2019, pp 399-417
2. Cohen R, Levy C, Bonacorsi S, et al: Diagnostic Accuracy of Clinical Symptoms and Rapid Diagnostic Test in Group A Streptococcal Perianal Infections in Children. Clin Infect Dis 2015 Jan 15;60:267-270