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Friday, January 28, 2011

SEPTIC UMBILICUS (OMPHALITIS)

Umbilical infection in the newborn is a common problem. The etiologic factors include poor sanitary conditions and local application of unsterile dressings. E.coli and staphylococcus are the most common organisms responsible for it.

It may present as
  • slight purulent discharge from localized infection of the stump,
  • umbilical abscess,
  • periumbilical cellulitis,or
  • umbilical gangrene
Even septicemia and neonatal tetanus may well regarded as forms of umbilical sepsis. If left untreated or inadequately treated, localized infection may be accompanied by formation of a pinkish, rounded, berry-like mass with granulation tissue. This is called umbilical granuloma. It is responsible for persistent serous discharge for several weeks or even months.
Prevention lies in aseptic care of the umbilicus, including its cutting. It is best left uncovered rather dressed with a binder.
Treatment consists in administering a broad spectrum antibiotic and local application of tripe dye or a powder/cream containing bactricin and neomycin. An umbilical granuloma would need cauterization by touching it with silver nitrate or copper sulfate crystal.

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