Omphalitis: Difference between revisions
| Line 27: | Line 27: | ||
**[[Ampicillin]] | **[[Ampicillin]] | ||
**[[Vancomycin]] | **[[Vancomycin]] | ||
**Consider [[clindamycin]] or [[metronidazole]] if concern for [[ | **Consider [[clindamycin]] or [[metronidazole]] if concern for [[anaerobes]] | ||
*Surgical consultation as indicated | *Surgical consultation as indicated | ||
Latest revision as of 19:25, 5 March 2020
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
- Acne
- Atopic dermatitis
- Candidiasis
- Contact dermatitis
- Diaper dermatitis
- Erythema toxicum neonatorum
- Impetigo
- Mastitis
- Milia
- Miliaria
- Mongolian spots
- Omphalitis
- Perianal streptococcal dermatitis
- Psoriasis
- Pustular melanosis
- Seborrheic dermatitis
- Sucking blisters
- Tinea capitis
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