Omphalitis

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