Omphalitis

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Background

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

Clinical Features

  • erythema of skin around umbilical stump
  • purulent drainage
  • fever

Workup

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

Treatment

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

Disposition

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


Source

Harwood Nuss, EMedicine

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