Isolated perianal<unk>  is only type of<unk>  that should be treated in ED
Consider either linear incision with packing, elliptical incision, or cruciate incision without packing
Frequent sitz baths
All perirectal<unk> es (ischiorectal, intersphincteric, supralevator) should be drained in the OR
All<unk> es require surgical referral and follow up
Consider either linear incision with packing, elliptical incision, or cruciate incision without packing
Frequent sitz baths
Causative organisms: Mixed infection with fecal flora for anaerobes and Gram Negatives (Bacteroides fragilis and  Escherichia coli)
Use is controversial
Only recommended in high risk patients:
Elderly
Diabetics
Systemic signs (fever, leukocytosis)
Valvular heart disease
Cellulitis
Immunosuppression
Possibly prevent fistula formation in otherwise healthy patients
Elderly
Diabetics
Systemic signs (fever, leukocytosis)
Valvular heart disease
Cellulitis
Immunosuppression
Treatment options:
Augmentin
Ciprofloxacin 500mg PO BID and Metronidazole 500mg PO TID
Anorectal abscess
Anal fissure
Anal fistula
Anal malignancy
Rectal prolapse
Anal tags
External hemorrhoid
Internal hemorrhoid