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Forum Name: Pediatric Topics

Question: Omphalitis in a 20 day old infant - Please Help!!!


 lievano - Thu Feb 09, 2006 4:36 pm

Please help:
A 20 day old female infant who lives in Mexico (full term, ceasarean birth, no complications) developped purulent discharge from the umbilicus site (after stump fell) about 5 days ago. Pediatrician at the time recommended topical Silver Oxide and topical antibiotic treatment.

Infant developped redness in the area and mild bleeding with continued discharge. A culture performed by my parents (who are doctors) was positive for Staphilococus Aureus.

No fever, good general state, good feeding.

Two pediatricians (including pediatric surgeon) consulted there have recommended conservative approach and observation.

Everything I read in the literature suggests that aggressive approach is warranted with IV antibiotic combination for both Gram + and Gram - germs.

Should we get up in arms with the local doctors and demand that this be done or should we follow their advise and wait and see? What accounts for the radically different opinion to what is found in the literature? One of the doctors says the vessels are closed by now and the risks of septicemia or other complications is minimal. Is this so? Is it really worth waiting? What is the relative risk of aggressive antibiotic treatment?

Please Help!!
 Theresa Jones, RN - Wed Nov 29, 2006 2:59 am

User avatar Hi lievano,
Conservative treatment may have been approached initially due to the fact why "overtreat" with strong IV antibiotics when minimal intervention takes care of the problem. Resistant staphylococcus aureus is the strain that would cause concern. If there was a sepsis concern, generally speaking, there would be signs/ symptoms suggesting such a condition not in the state that you expressed "No fever, good general state, good feeding". Hopefully all turned out well.
Sincerely,
Theresa Jones, RN

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