Perianal abscess in a 2-year-old presenting with a febrile seizure and swelling of the perineum

Abstract

An anorectal abscess, specifically a perianal abscess, is a relatively uncommon infection in children. It is a purulent fluid collection under the soft tissue outside the anus. Some of these abscesses may spontaneously drain and heal by themselves, while others may result in sepsis and require surgical intervention. The transition to a systemic illness requiring hospital admission is considered rare. We present the case of a 2-year-old male presenting with a febrile seizure and found to be systemically ill secondary to a perianal abscess. To our knowledge, this is the first case reported in the literature of a febrile seizure secondary to a perianal abscess.

Figure 1:

Clinical image demonstrating erythema and induration along the right perineal region consistent with cellulitis. This area was tracking anteriorly towards the scrotum with an associated perineal fluctuant mass

Figure 2:

Bedside ultrasound of the medial thigh revealed a cobblestone appearance, as noted by the arrows, indicating extensive soft tissue swelling/edema.

Figure 3:

Bedside ultrasound within the gluteal region revealed a small hypoechoic focus measuring up to 5 mm with an echogenic wall concerning for a small fluid collection