Streptococcal perianal infection in children.

How common is it? The incidence of perianal infection caused by group A S pyogenes is not known, but since the first case descriptions in 1966 it has been reported in children from around the world. In a US general paediatric practice, perianal streptococcal disease was detected in one consultation per 300, and perineal disease (that is, perianal plus vulvovaginal disease) in one per 200. A 1996 audit of our own practice (an urban British practice with 7000 patients and four full time general practitioners), found that 18 cases had been detected over two years by general practitioners highly aware of the condition—about one consultation per 1000 patients (children and adults combined).On this basis, the average general practitioner in the United Kingdommight expect to see childhood streptococcal perianal disease once or twice a year. It occurs in prepubertal children from infancy, with a peak incidence between the ages of 3 and 5 years.