ICD 10. P38.

9
Standar Kompetensi

Fukunda Izza Tamara

M. Ukrio Zefrizon
Sri Adeyana

Pembimbing
dr. Nazardi Oyong Sp.A

RSUD Arifin Achmad – FKUR

Background
Infection is the cause of high neonatus mortality.
One of them is omfalitis
WHO 33: 1000 live births
60% cause of death in neonate period
>> developing countries
Southeast Asia 30.5
Definition
 Omphalitis is the infection of the umbilicus area,
especially the cord in the newborn

>> the neonate period

Risk factors
Improper cord care
Secondary infection
Premature rupture of membrane
Mother with an infection
unsterile birth process
Prematurity
LBW
Risk factors
Other risk factors
Neonates with immunodeficiency
Leokocyte adhesion deficiency syndrome
Etiologies
 Aerobic bacteria
 Staphylococcus aureus >>
 Streptokokus grup A
 E- Coli
 Klebsiella
 Proteus
Etiologi
 Anerobic bacteria
 Bacteroides fragilis
 Peptostreptococcus
 Clostridium perfringens
Patomechanism
Risk Factors Improper cord care

Omfalitis

Enter through blood

vessels in the COMPLICATIONS
umbilicus
CLINICAL SYMPTOMS
LOCAL SYSTEMIC

•Purulent
•Takikardi
discharge
•Hypotension
• Smells bad
•CRT decreased
• Erythema
•Takipneu
• Edema
•Signs of respiratory
• Periumbilicity
failure
• Abdominal distension
•Decrease in bowel
sounds
CLINICAL SYMPTOMS
 Cont CNS

•Irritability
•Lethargy
•Decreased
suction reflex
•Hypotonus
•Hypertonus
Diagnosis
1. Wipe Microbiology
2. X-ray abdomen > if suspected necrotizing
enterocolitis
3. Abdominal ultrasound > if suspected intraperitoneal
abscess, retroperitoneal abscess
4. Ultrasound Doppler > portal vein thrombosis
5. Fistulogram > in case of fistula to umbilicus
6. MRI or CT-Scan > assess congenital fistulas
MANAGEMENT
Non
PHARMACOLOGY PHARMACOLOGY

Antibiotic
Proper Cord
Care

Aerob Anaerob
Management
 ANTIBIOTIC

Aerob Anaerob
•Ampiclox •Metronidazol
•Cloxacilin
•Fluxaciin Can be given 10-14 days
•Methicilin
•Meropenem
dikombinasi
dengan
gentamicin
Umbilical Cord Care
Dry Wet
Umbilical Cord Care
Treatment of dry umbilical cord
 1. Prepare the tools
2. Wash hands before and after treating the umbilical
cord
3. The cord is cleaned with gauze.
4. Once clean, the umbilical cord is wrapped with dry
sterile gauze.
5. After the umbilical cord is released, keep umbilical
cord sterile by giving sterile gauze.
Umbilical Cord Care
Treatment of wet umbilical cord
1. Prepare the tools
2. Wash hands thoroughly before commencing umbilical
cord care.
3. Clean the cord with alcohol from the base of the circle
upwards.
4. Cover with sterile gauze that is given alcohol and
replace it every time after bathing, sweating, exposed
dirty, and wet
5. Education to the mother, when the smell the odor
from the umbilical cord that has not been loose, take it
to the doctor.
Differential Diagnosis
 Omfaokel
 Umbilical cord granuloma
 Paten vitello Intesstinal sisa-sisa duktus
 Urachus Paten
 Necrotising enterocolitis
 General Sepsis
Complications
 Necrotising Fasciitis
Complications
 Peritonitis
 Abses
Prognosis
 Uncomplicated omfalitis > recovers rapidly
 Delayed treatment > morbidity and mortality
increased 7-15%
 Omphalitis with risk factors (Prematurity, LBW)
poor prognosis