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

Neonatal Rashes


Evaluation

  • CBC, BMP
  • Blood cultures
  • Septic workup if febrile neonate (UA, CXR, LP)
  • Imaging (ultrasound or CT) as indicated


Management

  • IV fluids NS 20mL/kg bolus if ill appearing
  • Antibiotics
    • Gentamycin
    • Ampicillin
    • Vancomycin
    • Consider clindamycin or metronidazole if concern for anaerobes
  • 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

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