Management of Perianal Abscess in Infants

Diagnosis

The primary symptom of perianal abscess in infants is pain, manifesting as irritability, and physical findings typically include swelling, erythema, and tenderness in the perianal region, according to the World Journal of Emergency Surgery 3, 4
Imaging studies are generally not required for typical presentations but may be considered in cases with atypical presentation, as recommended by the World Journal of Emergency Surgery 4

Incision and drainage is the cornerstone of treatment for perianal abscesses in infants, and the incision should be kept as close as possible to the anal verge to minimize potential fistula length while ensuring adequate drainage, as suggested by the World Journal of Emergency Surgery 1, 2, 3
Complete drainage is essential, as inadequate drainage is associated with high recurrence rates, and during the procedure, careful examination should be performed to identify any associated fistula tract, according to the World Journal of Emergency Surgery 2, 3

Antibiotics are not routinely indicated after adequate surgical drainage, but should be considered in cases of sepsis, significant surrounding soft tissue infection, disturbances of immune response, or incomplete source control, as recommended by the World Journal of Emergency Surgery 2, 3
If antibiotics are needed, broad-spectrum coverage for Gram-positive, Gram-negative, and anaerobic bacteria should be used, according to the World Journal of Emergency Surgery 2, 3

Close follow-up is essential to monitor for recurrence or fistula development, as suggested by the World Journal of Emergency Surgery is not the source, however, 5