Kaplan Ron L
From the Associate Professor, Division of Emergency Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA.
Pediatr Emerg Care. 2023 Mar 1;39(3):188-189. doi: 10.1097/PEC.0000000000002918.
Omphalitis is an uncommon but potentially serious infection in neonates. Findings include erythema and induration around the umbilical stump, and purulent drainage may be present. Fever and signs of systemic illness may occur, or there may only be signs of localized soft tissue infection. Until recently, there have been very few cohort studies of omphalitis in high-income countries, and no literature was available regarding the incidence of concurrent serious bacterial infection such as meningitis or urinary tract infection. A recent large, multicenter study suggests that most omphalitis presents as localized soft tissue infection, with very low rates of concurrent serious bacterial infection or adverse outcomes. Underlying urachal abnormalities should be considered in the infant with umbilical drainage. Treatment of omphalitis consists primarily of antibiotic administration, with surgical intervention rarely needed. Although antibiotics are typically administered intravenously, there may be a role for oral antibiotics in some lower risk infants with omphalitis.
脐炎是新生儿中一种不常见但可能很严重的感染。表现包括脐残端周围的红斑和硬结，可能有脓性分泌物。可能会出现发热和全身疾病的体征，也可能仅有局部软组织感染的体征。直到最近，高收入国家关于脐炎的队列研究很少，也没有关于并发严重细菌感染如脑膜炎或尿路感染发生率的文献。最近一项大型多中心研究表明，大多数脐炎表现为局部软组织感染，并发严重细菌感染或不良后果的发生率很低。脐部有分泌物的婴儿应考虑潜在的脐尿管异常。脐炎的治疗主要包括使用抗生素，很少需要手术干预。虽然抗生素通常通过静脉给药，但对于一些低风险的脐炎婴儿，口服抗生素可能也有作用。
