Omphalitis: Difference between revisions

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'''Background'''
==Background==
 
*acute infection of umbilical stump  
*acute infection of umbilical stump  
*rare  
*rare  
*can progress to severe cellulitis of abd wall, necrotizing fasc, sepsis
*can progress to severe cellulitis of abd wall, necrotizing fasc, sepsis


'''Clinical Features'''
==Clinical Features==
 
#erythema of skin around umbilical stump  
*erythema of skin around umbilical stump  
#purulent drainage  
*purulent drainage  
#fever
*fever
 
'''Workup'''


==Workup==
*CBC, BMP  
*CBC, BMP  
*blood cultures  
*blood cultures  
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*imaging (ultrasound or CT) as indicated
*imaging (ultrasound or CT) as indicated


'''Treatment'''
==Treatment==
 
#IV fluids NS 20mL/kg bolus if ill appearing  
*IV fluids NS 20mL/kg bolus if ill appearing  
#Abx
*Abx
##Gentamycin
##Ampicillin
##Vancomycin
#Surgical consultation as indicated


#Gentamycin
==Disposition==
#Ampicillin
#admit if febrile or ill appearing  
#Vancomycin
#consider d/c if very mild case and excellent follow-up assured
 
*surgical consultation as indicated
 
'''Disposition'''
 
*admit if febrile or ill appearing  
*consider d/c if very mild case and excellent follow-up assured
 
<br>
 
'''Source'''


==Source==
Harwood Nuss, EMedicine
Harwood Nuss, EMedicine


[[Category:Peds]]
[[Category:Peds]]
[[Category:GI]]

Revision as of 18:33, 14 September 2012

Background

  • acute infection of umbilical stump
  • rare
  • can progress to severe cellulitis of abd wall, necrotizing fasc, sepsis

Clinical Features

  1. erythema of skin around umbilical stump
  2. purulent drainage
  3. fever

Workup

  • CBC, BMP
  • blood cultures
  • septic workup if febrile neonate (UA, CXR, LP)
  • imaging (ultrasound or CT) as indicated

Treatment

  1. IV fluids NS 20mL/kg bolus if ill appearing
  2. Abx
    1. Gentamycin
    2. Ampicillin
    3. Vancomycin
  3. Surgical consultation as indicated

Disposition

  1. admit if febrile or ill appearing
  2. consider d/c if very mild case and excellent follow-up assured

Source

Harwood Nuss, EMedicine