Omphalitis

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