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Omphalitis: Clinical Presentation and Approach to Evaluation and Management.
1From the Associate Professor, Division of Emergency Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
Pediatric Emergency Care
|February 28, 2023
Summary
Omphalitis, a neonatal umbilical infection, is typically localized with low rates of serious complications. Most cases resolve with antibiotics, rarely requiring surgery.
Area of Science:
- Neonatal Medicine
- Pediatric Infectious Diseases
- Dermatology
Background:
- Omphalitis is an uncommon but potentially serious neonatal infection.
- Limited data existed on omphalitis incidence and concurrent serious bacterial infections in high-income countries.
Purpose of the Study:
- To evaluate the incidence and clinical presentation of omphalitis in neonates.
- To determine the rate of concurrent serious bacterial infections (e.g., meningitis, UTI) in neonates with omphalitis.
- To assess outcomes and treatment strategies for neonatal omphalitis.
Main Methods:
- A large, multicenter cohort study was conducted.
- Data on clinical findings, concurrent infections, and treatment outcomes were collected.
- Infants with umbilical drainage were evaluated for underlying urachal abnormalities.
Main Results:
- Most omphalitis cases presented as localized soft tissue infections.
- Rates of concurrent serious bacterial infection and adverse outcomes were very low.
- Antibiotic administration is the primary treatment; surgical intervention is rarely needed.
Conclusions:
- Neonatal omphalitis is predominantly a localized infection with a favorable prognosis.
- Serious bacterial infections are uncommon comorbidities.
- Oral antibiotics may be suitable for lower-risk infants, alongside IV antibiotics for severe cases.
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