title: [Group A streptococcal perineal infection in children].
abstract: Perineal diseases in children are usually caused by group A streptococcus (GAS). If the natural course of untreated cases is not known, it is well known that symptoms do not resolve spontaneously and can persist often for many months, until appropriate diagnosis and effective treatment are instituted. Furthermore, failures and recurrences after penicillin treatment are frequent. From 2009 to 2014, 165 perineal infections (median age: 48 months, extremes: 0.4-139) were enrolled by 15 pediatricians: 4 balanitis, 29 vulvo-vaginal diseases and 132 perianal infections. Painful defecation, anal fissures and macroscopic blood in stools were significantly more frequent in GAS perianal infections than negative GAS infections (p<0.01). The performance of GAS-rapid antigen test compared to the GAS culture was : sensitivity 97 % [CI 95 %: 89-100 %], specificity 76 % [CI 95 %: 66-84 %], negative predictive value 97 % [CI 95 %: 91-100 %], positive predictive value 71 % [CI 95 %: 60-80 %].
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.
authors.forename: M
authors.initials: M
authors.lastname: Koskas
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; Centre de recherche clinique (CRC) et Centre hospitalier intercommunal (CHI), 40, avenue de Verdun, 94010 Créteil, France; AFPA (Association française de pédiatrie ambulatoire), 4, rue Parmentier, 54270 Essey-les-Nancy, France. Electronic address: corinne.levy@activ-france.fr.
authors.forename: C
authors.initials: C
authors.lastname: Levy
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.
authors.forename: O
authors.initials: O
authors.lastname: Romain
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.
authors.forename: C
authors.initials: C
authors.lastname: Schlemmer
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France.
authors.forename: S
authors.initials: S
authors.lastname: Béchet
authors.affiliation: Université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France; Service de microbiologie, hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Bonacorsi
authors.affiliation: Université Paris-Diderot, PRES Sorbonne-Paris-Cité, 46, rue Henri-Huchard, 75018 Paris, France; Service de microbiologie, hôpital Robert-Debré (AP-HP), 48, boulevard Sérurier, 75019 Paris, France.
authors.forename: Ph
authors.initials: P
authors.lastname: Bidet
authors.affiliation: ACTIV (Association clinique et thérapeutique infantile du Val-de-Marne), 27, rue Inkermann, 94100 Saint-Maur-des-Fossés, France; Centre de recherche clinique (CRC) et Centre hospitalier intercommunal (CHI), 40, avenue de Verdun, 94010 Créteil, France; AFPA (Association française de pédiatrie ambulatoire), 4, rue Parmentier, 54270 Essey-les-Nancy, France; Unité court séjour, petits nourrissons, service de néonatologie, CHI de Créteil, 40, avenue de Verdun, 94010 Créteil, France.
authors.forename: R
authors.initials: R
authors.lastname: Cohen
mesh_terms: D000942:Antigens, Bacterial / Q000032:analysis; D001004:Anus Diseases / Q000175:diagnosis* / Q000382:microbiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France; D006801:Humans; D007159:Immunologic Tests; D007223:Infant; D008297:Male; D010409:Penile Diseases / Q000175:diagnosis* / Q000382:microbiology; D017192:Skin Diseases, Bacterial / Q000175:diagnosis* / Q000382:microbiology; D013290:Streptococcal Infections / Q000175:diagnosis* / Q000188:drug therapy; D013297:Streptococcus pyogenes / Q000276:immunology; D014623:Vaginal Diseases / Q000175:diagnosis* / Q000382:microbiology; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000382:microbiology
chemical_list: D000942:Antigens, Bacterial