What causes omphalitis?

Updated: May 20, 2019
  • Author: Patrick G Gallagher, MD; Chief Editor: Santina A Zanelli, MD  more...
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Answer

Omphalitis occasionally manifests from an underlying immunologic disorder. Leukocyte adhesion deficiency (LAD) is most prominent among the immunodeficiency syndromes. [10, 11, 12, 13, 14, 15, 16] Numerous infants with acute or chronic omphalitis have been diagnosed with LAD, a rare immunologic disorder with an autosomal recessive pattern of inheritance. These infants typically present with the following:

  • Leukocytosis

  • Delayed separation of the umbilical cord, with or without omphalitis

  • Recurrent infections

Omphalitis may also be the initial manifestation of neutrophil disorders in the neonate, including neonatal alloimmune neutropenia and congenital neutropenia. [17, 18, 19, 20] Affected infants may present with other cutaneous infections, pneumonia, sepsis, and meningitis.

Neonatal alloimmune neutropenia is a disease analogous to Rh-hemolytic disease and results from maternal sensitization to fetal neutrophils bearing antigens that differ from the mother's. [21] Maternal immunoglobulin G antibodies cross the placenta and result in an immune-mediated neutropenia that can be severe and last for several weeks to 6 months. [22]

The congenital neutropenias are a disease group of heterogeneous disorders that range from intermittent to persistent manifestations of varying severity. [23]

Because omphalitis complicated by sepsis can also be associated with neutropenia, the underlying immune-mediated neutrophil destruction may not be immediately appreciated in affected newborns.

Rarely, an anatomic abnormality such as a patent urachus, a patent omphalomesenteric duct, or a urachal cyst may be present. [24, 25, 26, 27, 28]


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