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Anusitis secondary to bacterial infection.

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Hi I'm a 26 year old female. I have been experiencing an inflamed perineum and a buldge on my anus. The perineum is red and swollen whereas the buldge is slightly lighter than my skin. I have a regular bowel movement so I doubt that it could be an external hemmaroid. The buldge does not hurt but there is an associated irritation including itching.
I have a great hygiene. I used to use butt wipes but I stopped because I thought it may have been an irritation due to the butt wipes. My initial symptoms began about a month ago where I only had an inflamed perineum. The buldge/lump I feel has developed over time.
It may be important to note that I had a coccygeal block about a month ago (when my symptoms began) and I believe I had a reaction to the steroid shot because I experienced an intense and increased pain in my coccyx and Lowe back.
I hope you are able to give me some guidance.
Thank you.

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
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Thank you for choosing DoctorSpring.

The inflamed perineum could be due to a number of causes. Termed as anusitis - this could arise from infections such as Shigella, salmonella, or from IBD (Inflammatory Bowel Disease )

The swelling description matches with Haemorrhoids, BUT haemorrhoids will not have surrounding perennial inflammation and symptoms. So it could be a coexisting haemorrhoids. Another possibility is a infected cyst or abscess. (Less likely as they are not very much tender). Steroid injections can also cause inflammation.

A single diagnosis at this stage would be difficult. A step by step approach is needed. For now you can apply Preparation H OTC (1% Hydrocortisone cream). This will take care of the inflammation (regardless of the cause). Do not use for more than a week. Take high fibre diet. DO NOT strain while passing stool. DO NOT use strong soaps or irritants. Clean with water only.

This should take care of the symptoms. Beyond a week the symptoms you will need a physical examination (per rectal examination ) and some baseline tests.

I would like to know where there is a recent history of any high risk sexual exposure. Also do you have any abdominal symptoms such as bloating, pain, diarrhoea etc.

Hope this helps
Feel free to ask followups
Thank you

Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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