Omphalitis

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

Diagnosis

• 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
• Antibiotics
  • Gentamycin
  • Ampicillin
  • Vancomycin
• 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