Omphalitis: how to treat the (rare) umbilical infection typical of newborns
When it comes to a baby's health, every expectant mother tries to inform herself as much as possible about possible postpartum complications. However, it is good to distinguish between frequent pathologies in newborns and rarer diseases, which in any case can be treated with specific treatments, if taken in time. Today we will deepen the theme of "omphalitis, but first here is a video to find out how big a baby is month by month in pregnancy.
Omphalitis in the newborn: what it is
Omphalitis is one of the infections found in newborns, in very few cases it has occurred in adults. This is why when we talk about this topic, we mainly refer to the population of very small children (even premature babies), just born in the world. also the name of granuloma or navel fungus.
It is an inflammatory disease that is confined to the umbilical area and neighboring tissues.
Often the inflammation is accompanied by foul-smelling secretions which fortunately disappear within a few days, if properly treated with hydrogen peroxide and disinfectant ointments. In some cases the omphalitis evolves in a serious way, particularly in those patients characterized by a compromised immune system , hospitalized or those who undergo invasive procedures.
The "severe" infection has cysts visible to the eye, which need to be removed surgically.
How does "neonatal omphalitis appear?" The inflammation of the umbilical stump can be recognized by its specific appearance: it almost looks like a superficial cellulite that spreads in the abdominal area of the baby; in the most at-risk situations it can even evolve into necrotizing fasciitis.
As we have anticipated previously, this disorder, in Italy and in other industrialized countries, is actually very rare, unlike the less developed areas where unfortunately it remains a common cause of infant mortality. So you don't have to worry if your baby's stump looks inflamed; share photos of her tummy with the pediatrician who will almost certainly reassure you.
If you want to know more about neonatal omphalitis read on!
See also
-tipica-dei-neonati.jpg)
-tipica-dei-neonati_2.jpg)
-tipica-dei-neonati_3.jpg)
-tipica-dei-neonati_4.jpg)
Causes of neonatal omphalitis
In most cases this disorder is caused by a "bacterial infection: those involved are both Gram-positive and Gram-negative and the most common appear to be Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Klebsiella pneumoniae and the Proteus mirabilis.
Only in rare cases does omphalitis emerge from only one type of microorganism.
Of course, the umbilical stump is colonized by some potential pathogens (ie bacteria) both in labor and immediately after delivery, and it seems that these attract white blood cells to the umbilical cord.
We do not know precisely what mechanisms are hidden in the act of separating the umbilical cord from the maternal organism, but it has been studied how this particular influx of leukocytes and subsequently the drying of the cord contributes to the development of the white patina of the stump, which then it will go to fall.
In fact, if you think about it, the little piece of cord left over from the moment of delivery is a wound, and consequently a potential "ready" area for bacteria to grow.
Omphalitis occurs precisely when this neonatal "wound" is invaded by microbes.
Unfortunately, this is what has been discovered so far regarding the triggering causes of the inflammation; the factors that provoke the advance of colonization and the consequent evolution into actual infection remain unknown.
And in adults? In those few adult patients it was found that one of the triggering causes is the late fall of a part of the stump, which can also occur after 30 years of age!
When expelled, it causes a small dermatological laceration which immediately creates free access for bacteria. Omphalitis for adults is not to be underestimated, because although rarely, and if not treated, it can lead to serious complications.
-tipica-dei-neonati_5.jpg)
Symptoms of omphalitis in the newborn
How to recognize omphalitis in the small?
At the beginning this disorder presents symptoms very similar to those of infectious cellulite, and therefore severe pain in the affected area and swelling.
Premature babies can also experience jaundice, tachycardia, and hypotension.
This persistent discomfort is often accompanied by edema, periumbilical erythema and heartburn.
If you suspect that your child has a possible omphalitis, contact the pediatrician immediately who will be able to guide you in the path of care to be taken to make him feel better.
It is really important to be informed on this issue, because if it is not treated in time, omphalitis can get complicated and give rise to other serious pathologies: advancing beyond the subcutaneous tissues, in fact, it also involves the muscles of the abdominal wall, leading to myonecrosis, and if bacteria reach the umbilical vessels and veins, it leads to phlebitis.
For the sake of completeness, here are all the symptoms of neonatal omphalitis (in bold you will find the most common ones, which can also occur together):
- Skin abscess
- Asthenia
- Bacteremia
- Bubbles
- Abdominal pain
- Pain in the Navel
- Muscle aches
- Edema
- Erythema
- Fever
- Formation of pus
- Hypotension
- Enlarged lymph nodes
- Headache
- Petechiae
- Tachycardia
Also pay close attention to additional warning signs such as a constant rise in body temperature, difficulty breathing (apnea, especially at night), gastrointestinal upset, irritability and severe sleepiness throughout the day.
-tipica-dei-neonati_6.jpg)
Diagnosis and treatment of omphalitis
The diagnosis of omphalitis is of a clinical nature and initially consists in "carefully observing the stretch of cord that has remained attached to the child. Later on, the presence of the disorder is ascertained through blood analysis and biopsy of a sample.
If the pediatrician suspects omphalitis, congenital umbilical fistulas, which are associated with purulent secretions, must be involved in the diagnosis.
Treatment of the disease in children is not complicated at all: the patient must undergo specific antibiotic therapy. Usually omphalitis is treated with penicillin or with aminoglycosides, depending on the type of bacterium that has infected the abdominal area.
If, on the other hand, you are faced with a case of invasive infection, it is possible to take, always on the doctor's prescription, a mix of antibiotics including metronidazole.
How long does the treatment of omphalitis last? It is advisable to administer drugs for at least 10-15 days, based on the nature and severity of the infection.
Remember that it is up to the doctor to choose the most suitable active ingredient and dosage for small patients.
Surely if necrotizing fasciitis is found, the approach is much more aggressive because it is a serious complication of the infection.
Let's see in detail what are the most worrying complications.
-tipica-dei-neonati_7.jpg)
What are the complications of neonatal omphalitis?
Let us now deal with those cases that are very rare, and which hopefully you will never have to deal with.
- The complication that most frightens mothers is necrotizing fasciitis; what is it about? Basically it is a serious infection of the skin and the fat under it and affects about 8 to 16% of the total cases of neonatal omphalitis, which in the final phase leads to the death of soft tissues. You recognize it because it spreads quickly and is highly toxic. It is concentrated in the abdominal area; only in boys can it even go to the scrotum and penis.
- Another worrying worsening of omphalitis is myonecrosis. In this case the muscles are involved and it develops when there are conditions that allow the growth of anaerobic organisms.What are these conditions? Presence of necrotic tissue, poor blood supply, foreign material or infection through specific aerobic bacteria.
- Sepsis. Perhaps the most common of the complications of the disease; disseminated intravascular coagulation (DIC) and damage to different organs occur.
- Septic embolism. It involves the umbilical vessels which are infected. It can lead to the development of metastatic foci in various organs, such as the heart, liver, lungs, pancreas, kidneys, and skin.
What does neonatal omphalitis involve in the long term? If the disease persists, some consequences could be portal vein thrombosis, extrahepatic portal hypertension and biliary tract obstruction.
