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Umbilical gangrene in the newborn
R J Stunden1, R A Brown, H Rode
1Department of Paediatric Surgery, Red Cross War Memorial Children's Hospital, Rondebosch, Republic of South Africa.
Journal of Pediatric Surgery
|February 1, 1988
Summary
Gangrenous omphalitis, a severe newborn infection, led to death in five infants despite aggressive treatment. A sixth infant survived after evolving therapy, highlighting the disease
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pediatric Surgery
Background:
- Gangrenous omphalitis is a rare and severe umbilical cord infection in newborns.
- This condition has not been widely reported in recent medical literature.
- The study describes six cases with common clinical and microbiological features.
Purpose of the Study:
- To describe the clinical presentation, pathology, and microbiology of gangrenous omphalitis.
- To discuss the therapeutic challenges and evolution of treatment for this severe neonatal infection.
- To report on a successful treatment outcome in a neonate with gangrenous omphalitis.
Main Methods:
- Retrospective case series analysis of six neonates with gangrenous omphalitis.
- Clinical data collection including patient history, physical examination, and treatment course.
- Microbiological and pathological examination of infected tissues and assessment of infant immune status.
Main Results:
- Five of the six neonates died despite aggressive interventions, including surgical excision.
- Common features included prior good health, umbilical gangrene, cellulitis, and polybacterial infection (E. coli, Clostridia).
- Pathology revealed local necrosis, vasculitis, microabscesses, and systemic endotoxemia/exotoxemia.
Conclusions:
- Gangrenous omphalitis is a highly lethal neonatal infection with rapid systemic progression.
- Aggressive surgical and medical management is critical, but often insufficient.
- Therapeutic evolution led to a successful outcome in one case, suggesting potential treatment strategies.