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Cephalhematomas revisited. When should a diagnostic tap be performed?
C M LeBlanc1, U D Allen, E Ventureyra
1Division of General Pediatrics and Infectious Diseases, Children's Hospital of Eastern Ontario, Ottawa, Canada.
Clinical Pediatrics
|February 1, 1995
Summary
Diagnosing infected cephalhematomas requires careful evaluation. Aspiration is the preferred method when infection is suspected, especially with clinical signs of scalp infection or sepsis.
Area of Science:
- Pediatric Infectious Diseases
- Neonatal Care
- Surgical Pathology
Background:
- Cephalhematomas are common neonatal conditions.
- Investigating infection in cephalhematomas is crucial for appropriate management.
- Limited data exists on optimal diagnostic methods for infected cephalhematomas.
Observation:
- A review of literature from 1972-1993 identified 13 cases of infected cephalhematomas.
- Escherichia coli was the most common pathogen isolated from aspirated cephalhematomas.
- Clinical signs included scalp infection, sepsis, meningitis, and osteomyelitis.
Findings:
- Plain radiographs, bone scans, and CT scans showed limited utility in diagnosing infected cephalhematomas unless osteomyelitis was present.
- Diagnostic aspiration is the most appropriate method for investigating suspected cephalhematoma infections.
- Indications for aspiration include increasing size, erythema, fluctuance, or persistent/relapsing infection.
Implications:
- Early and accurate diagnosis of infected cephalhematomas is vital to prevent severe complications.
- Aspiration provides definitive diagnosis and allows for targeted antimicrobial therapy.
- This review clarifies diagnostic indications, guiding clinicians toward timely intervention.