What is the focus of clinical history in the evaluation of omphalitis?

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

A detailed review of the pregnancy, labor, delivery, and the neonatal course is important when assessing omphalitis. Note the following:

  • A history of poor feeding or feeding intolerance may be an early indication of infection. A history of change in mental status, such as irritability, lethargy, and somnolence, or a history of a decreased level of activity may be an important indicator of systemic dissemination of the infection.

  • Anaerobic bacteria are part of the normal flora of the female genital tract and are commonly involved in ascending infections of the uterus and in septic complications of pregnancy; therefore, the higher incidence of omphalitis caused by anaerobes (especially B fragilis) in infants with adverse perinatal histories, such as premature or prolonged rupture of membranes and amnionitis, may relate to exposure to maternal infection.

  • History of urine or stool discharge from the umbilicus suggests an underlying anatomic abnormality.


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