Conclusion
This case represents an unusual presentation of scarlet fever manifesting as perianal dermatitis caused by GABHS. Although more common in the pediatric population, adult cases have been documented in the literature. As this case illustrates, early recognition and treatment with penicillin (or amoxicillin) produces rapid improvement and resolution of symptoms.
Dr Nibhanipudi is a professor of clinical emergency medicine at New York Medical College - Metropolitan Hospital Center, New York.