What is the role of lab testing in the workup of omphalitis?

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

Routinely obtain specimens from umbilical infection and submit specimens for Gram stain and culture for aerobic and anaerobic organisms. If myonecrosis is suspected, obtain specimens from the involved muscle rather than the wound surface.

Obtain blood cultures for aerobic and anaerobic organisms.

Obtain a complete blood cell (CBC) count with manual differential. Neutrophilia or neutropenia may be present in acute infection. An immature-to-total neutrophil ratio greater than 0.2 may be a useful indicator of systemic bacterial infection in the first few days of life. Thrombocytopenia may be present.

Other nonspecific laboratory tests, either alone or in combination with a defined scoring system, have been evaluated for their usefulness in rapid detection of bacterial infection in neonates, although none has demonstrated sensitivity or specificity sufficiently high to dictate clinical care. The tests include the following:

  • C-reactive protein levels

  • Procalcitonin

  • Erythrocyte sedimentation rate

  • Neutrophil CD64


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