Case 10

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This photo demonstrates a finding observed on a 3-year-old boy with perianal itching and pain. He has had a few blood-streaked stools. His mother has been applying nystatin cream to the area, but it continues be inflamed and sharply demarcated. She denies any history of sexual abuse or trauma to his rectal area.

Image description below
Source: A. S. Botash, MD, used with permission

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A photo of the anus of a male child in the knee-chest position with erythema and induration surrounding the anus.

Which of the following statements is most likely?

A. This is a case of resistant Candida.

B. The redness is likely from chronic abuse and a hotline report should be made.

C. Thayer Martin is the most appropriate culture media for a diagnosis.

D. A throat culture will likely reveal the same organism as a culture of the perianal area.

E. C and D.