Omphalitis: Difference between revisions
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==Background== | ==Background== | ||
* | *Acute infection of umbilical stump | ||
* | *Rare | ||
==Clinical Features== | ==Clinical Features== | ||
*Erythema of skin around umbilical stump | |||
*Purulent drainage | |||
*[[Fever]] | |||
== | ==Differential Diagnosis== | ||
*[[Cellulitis]] of abdominal wall | |||
*[[Necrotizing fasciitis]] | |||
*[[Neonatal sepsis]] | |||
{{Neonatal rashes DDX}} | |||
==Evaluation== | |||
*CBC, BMP | *CBC, BMP | ||
* | *Blood cultures | ||
* | *Septic workup if febrile neonate ([[UA]], [[CXR]], [[LP]]) | ||
* | *Imaging (ultrasound or CT) as indicated | ||
== | ==Management== | ||
*IV fluids NS 20mL/kg bolus if ill appearing | |||
*[[Antibiotics]] | |||
**[[Gentamycin]] | |||
**[[Ampicillin]] | |||
**[[Vancomycin]] | |||
**Consider [[clindamycin]] or [[metronidazole]] if concern for [[anaerobes]] | |||
*Surgical consultation as indicated | |||
==Disposition== | ==Disposition== | ||
*Admit if febrile or ill appearing | |||
*Consider discharge if very mild case and excellent follow-up assured | |||
== | ==References== | ||
Harwood Nuss, EMedicine | Harwood Nuss, EMedicine | ||
[[Category: | [[Category:Pediatrics]] | ||
[[Category:GI]] | [[Category:GI]] | ||
[[Category:ID]] | |||
Latest revision as of 19:25, 5 March 2020
Background
- Acute infection of umbilical stump
- Rare
Clinical Features
- Erythema of skin around umbilical stump
- Purulent drainage
- Fever
Differential Diagnosis
- Cellulitis of abdominal wall
- Necrotizing fasciitis
- Neonatal sepsis
Neonatal Rashes
- Acne
- Atopic dermatitis
- Candidiasis
- Contact dermatitis
- Diaper dermatitis
- Erythema toxicum neonatorum
- Impetigo
- Mastitis
- Milia
- Miliaria
- Mongolian spots
- Omphalitis
- Perianal streptococcal dermatitis
- Psoriasis
- Pustular melanosis
- Seborrheic dermatitis
- Sucking blisters
- Tinea capitis
Evaluation
- CBC, BMP
- Blood cultures
- Septic workup if febrile neonate (UA, CXR, LP)
- Imaging (ultrasound or CT) as indicated
Management
- IV fluids NS 20mL/kg bolus if ill appearing
- Antibiotics
- Gentamycin
- Ampicillin
- Vancomycin
- Consider clindamycin or metronidazole if concern for anaerobes
- Surgical consultation as indicated
Disposition
- Admit if febrile or ill appearing
- Consider discharge if very mild case and excellent follow-up assured
References
Harwood Nuss, EMedicine