Omphalitis

  • Mohamed Fahmy
Chapter

Abstract

The umbilical cord as a vital port conveying the whole embryonic blood from the mother, will be changed to a daed scar after delivery within 2 weeks, this critical change may pass smoothly if the circumstance around the umbilical stump is optimal, but if this stump contaminated with pathogenic bacteria or the immunity of the baby compromised, umbilical stump could be a potential port for entry of pathogenic microorganisms, not only to the skin around umbilicus, but also to portal and systemic circulation, ending with a significant morbidity and mortality. Common cases of omphalitis are those affecting the umbilicus after separation of umbilical stump, rarely adult or an elder may have an omphalitis secondary to bacterial or other pathogenic infection, also non infectious inflammation of the umbilical scar are called omphalitis; but it is actually a sort of dermatitis. Neonatal omphalitis at one time was a common cause of mortality in neonates allover the world, nowadays with the application of potent antiseptics to the cord stump especially in the western countries, and after application of the preventive guidelines, published by WHO, the incidence has decreased remarkably. The incidence is now between 0.5 and 2%. The mean age of developing omphalitis is 3.2 days, and most cases occur outside the hospitals. Although the preventive measure are effective in reducing this sort of infection, medical treatment is simple and curative, but undetected or neglected cases may end with lethal outcome.

Keywords

Omphalitis Funisitis Umbilical stump Catarrhal omphalitis Phlegmonous omphalitis Necrotizing fasciitis Myonecrosis myiasis Lint ball omphalitis Ompholith 

References

  1. 1.
    Bugaje MA, et al. “Omphalitis”. Paediatric surgery: a comprehensive text for Africa. Retrieved 23 July 2013.Google Scholar
  2. 2.
    Sawardekar KP. Changing spectrum of neonatal omphalitis. Pediatr Infect Dis J. 2004;23(1):22e6.CrossRefGoogle Scholar
  3. 3.
    Simiyu DE. Morbidity and mortality of neonates admitted in general paediatric wards at Kenyatta National Hospital. East Afr Med J. 2003;80:611–6.PubMedGoogle Scholar
  4. 4.
    McKenna H, Johnson D. Bacteria in neonatal omphalitis. Pathology. 1977;9(2):111e3.CrossRefGoogle Scholar
  5. 5.
    Schlesinger AE, Braverman RM, DiPietro MA. Neonates and umbilical venous catheters: normal appearance, anomalous positions, complications, and potential aid to diagnosis. Am J Roentgenol. 2003;180:1147–53.CrossRefGoogle Scholar
  6. 6.
    Moens E, De Dooy J, Jansens H, Lammens C, de Beeck BO, Mahieu L. Hepatic abscesses associated with umbilical catheterisation in two neonates. Eur J Pediatr. 2003;162(6):406–9.PubMedGoogle Scholar
  7. 7.
    Brook I. Microbiology of necrotizing fasciitis associated with omphalitis in the newborn infant. J Perinatol. 1998;18(1):28–30.PubMedGoogle Scholar
  8. 8.
    Fraser N, Davies BW, Cusack J. Neonatal omphalitis: a review of its serious complications. Acta Paediatr. 2006;95(5):519–22.CrossRefPubMedGoogle Scholar
  9. 9.
    Sawin RS, Schaller RT, Tapper D, et al. Early recognition of neonatal abdominal wall necrotizing fasciitis. Am J Surg. 1994;167(5):481–4.CrossRefPubMedGoogle Scholar
  10. 10.
    Bingol-Kologlu M, Yildiz RV, Alper B, et al. Necrotizing fasciitis in children: diagnostic and therapeutic aspects. J Pediatr Surg. 2007;42(11):1892–7.CrossRefPubMedGoogle Scholar
  11. 11.
    Weber DM, Freeman NV, Elhag KM. Periumbilical necrotizing fasciitis in the newborn. Eur J Pediatr Surg. 2001;11(2):86–91.CrossRefPubMedGoogle Scholar
  12. 12.
    Samuel M, Freeman NV, Vaishnav A, et al. Necrotizing fasciitis: a serious complication of omphalitis in neonates. J Pediatr Surg. 1994;29(11):1414–6.CrossRefPubMedGoogle Scholar
  13. 13.
    Mason WH, Andrews R, Ross LA, Wright HT Jr. Omphalitis in the newborn infant. Pediatr Infect Dis J. 1989;8(8):521–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Moon SB, Lee HW, Park KW, Jung SE. Falciform ligament abscess after omphalitis: report of a case. J Korean Med Sci. 2010;25:1090–2.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Orloff MJ, Orloff MS, Girard B, Orloff SL. Bleeding esophageal varices from extrahepatic portal hypertension: 40 years experience with portal-systemic shunt. J Am Coll Surg. 2002;194:717–30.CrossRefPubMedGoogle Scholar
  16. 16.
    Imdad A, Bautista RM, Senen KA, Uy ME, Mantaring JB, Bhutta ZA. Umbilical cord antiseptics for preventing sepsis and death among newborns. Cochrane Database Syst Rev. 2013;5:CD008635. doi: 10.1002/14651858.CD008635.pub2.Google Scholar
  17. 17.
    Vause Greig GW, Shucksmith HS. Primary umbilical sepsis in the adult: report of seven cases. Lancet. 1950;255(6593):4–6.CrossRefGoogle Scholar
  18. 18.
    Coda A, Bossotti M, Ferri F, et al. Incisional hernia and fascial defect following laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2000;10(1):34–8.CrossRefPubMedGoogle Scholar
  19. 19.
    Koenig LM, Carnes M. Body piercing, medical concerns with cutting-edge fashion. J Gen Intern Med. 1999;14(6):379–85.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Gold MA, et al. Body piercing practices and attitudes among urban adolescents. J Adolesc Health. 2005;36(4):352.e15–352.e2.CrossRefGoogle Scholar
  21. 21.
    Ogbalu OK, Eze CN, Manuelrb B. A new trend of Omphalitis complicated with Myiasis in neonates of the Niger Delta, Nigeria. Epidemiology (Sunnyvale). 2016;6:2. doi: 10.4172/2161-1165.1000231.Google Scholar
  22. 22.
    Patra S, Purkait R, Basu R, Konar MC, Sarkar D. Umbilical myiasis associated with Staphylococcus Aureus sepsis in a neonate. J Clin Neonatol. 2012;1:42–3.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Thwaites CL, Beeching NJ. CRNewton: maternal and neonatal tetanus. Lancet. 2015;385:362–70.CrossRefPubMedGoogle Scholar
  24. 24.
    Hatkar N, Shah N, Imran S, Jadhao A. Study of incidence, Mortality & Causes of neonatal tetanus among all neonatal intensive care unit [NICU] admissions in tertiary health care center of SBHGMC, Dhule. J Evol Med Dent Sci. 2015;4(40):6967–73. doi: 10.14260/jemds/2015/1012.CrossRefGoogle Scholar
  25. 25.
    Steinhauser G. The nature of navel fluff. Med Hypotheses. 2009;72:623–5. doi: 10.1016/j.mehy.2009.01.015.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Mohamed Fahmy
    • 1
  1. 1.Pediatric SurgeryAl Azher University Pediatric SurgeryCairoEgypt

Personalised recommendations