Omphalitis

Template

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FindingsChoose oneFirst line

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CordChoose one

Risk factorsChoose any

ReviewedChoose any

Systemic signs presentChoose any

Systemic signs absentChoose any

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Follow-upChoose oneNot in the note with these choices

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Counseling

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

CounselingNot in the note with these choices

Discussed the need for hospital admission today. Caregiver expressed understanding and agreement with plan. Answered all questions.

Note when inserted as is

Omphalitis
Redness, swelling, and tenderness around the umbilicus with drainage
• Cord care, onset, fever, feeding, and behavior reviewed
• No fever, ill appearance, poor feeding, or purple skin, blisters, or crackling under the skin
• Sent to the emergency department for evaluation and treatment given omphalitis in a young infant

Discussed the need for emergency evaluation today. Caregiver expressed understanding and agreement with plan. Answered all questions.

What the sources cover

Funisitis, periumbilical cellulitis, spreading redness (AAP grades 1-2)
Systemic signs and necrotizing fasciitis (AAP grades 3-4)
Outpatient Keflex or Clindamycin for a well-appearing, afebrile infant over 28 days with localized redness
Wound culture
Dry cord care

Return precautions in the template

redness that spreadsfeverpoor feedingunusual sleepiness or fussinesspurple skin or blisters around the belly button

Sources

AAP Clinical Report: Umbilical Cord Care in the Newborn Infant. Stewart D, Benitz W; Committee on Fetus and Newborn. Pediatrics 2016;138(3):e20162149. (free; the page…
Kaplan RL et al. Omphalitis and Concurrent Serious Bacterial Infection. Pediatrics 2022;149(5):e2021054189. (abstract only; original study, evidence for one question)