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Omphalitis, Pediatric

Jessica P. Clarke-Pounder, MD and W. Christopher Golden, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Omphalitis, a bacterial infection of the umbilical stump, begins in the neonatal period as a superficial cellulitis but may track along umbilical vessels and progress to systemic ill...

DIAGNOSIS

HISTORY

  • Identify risk factors such as prolonged membrane rupture and septic delivery.

  • Symptoms such as fever, irritability, lethargy, respiratory distress, or feeding intolerance may indicate ...

TREATMENT

GENERAL MEASURES

Antibiotics and supportive care 

MEDICATION

Empiric coverage 
  • Antistaphylococcal agent (oxacillin, vancomycin) plus an aminoglycoside (e.g., gentamicin) or cefepime

  • Consider loca...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Infants developing associated portal venous thrombosis require follow-up for complications owing to portal hypertension. 

PROGNOSIS

  • The outcome of infants with unco...

ADDITIONAL READING

  • Ameh E, Nmadu P. Major complications of omphalitis in neonates and infants. Pediatr Surg Int.  2002;18(5–6):413–416. [View Abstract on OvidInsights]

  • Anderson J, Philip A. Manage...

CODES

ICD9

  • 771.4 Omphalitis of the newborn

  • 041.00 Streptococcus infection in conditions classified elsewhere and of unspecified site, streptococcus, unspecified

  • 041.10 Staphylococcus infection in conditi...

FAQ

  • Q: Do all infants require antiseptic treatment of the umbilical cord?

  • A: No. Infants born in a hospital setting can be treated with clean, dry cord care. In developing countries or in a circumstanc...

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