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Delayed Presentation of Neonatal Omphalitis with Suspected Invasive Soft-Tissue Infection and Late-Onset Sepsis Following Non-Sterile Home Delivery: A Case Report

Year: 2026

Type: article

Abstract: Background: Neonatal omphalitis can progress from a localized umbilical infection to invasive soft-tissue and systemic infection, especially when presentation is delayed. Diagnostic and surgical assessment may be limited in resource-constrained settings. Case Presentation: A 19-day-old female neonate presented after approximately two weeks of umbilical symptoms following non-sterile home delivery and cord tying with non-sterile cloth. Fever, poor feeding, purulent discharge, abdominal distension, periumbilical inflammation and necrotic-appearing tissue were documented. The admission white blood cell count was 50 × 10 3 /μL. She was treated in the neonatal intensive care unit with intravenous ampicillin, cefotaxime and vancomycin, supportive care and local wound management. Clinical deterioration continued over five documented hospital days, followed by death on an unspecified subsequent day. No microbiological confirmation or imaging findings are available in the report. The extent of deep-tissue or intra-abdominal involvement could not be established. Conclusion: This case illustrates delayed presentation of omphalitis with clinical features concerning for late-onset neonatal sepsis and possible invasive soft-tissue infection. Early assessment, cultures when feasible, reassessment of antimicrobial response, and prompt surgical evaluation for necrotic tissue are important considerations; the contribution of specific omitted investigations or interventions to this outcome cannot be established. Keywords: neonatal omphalitis, late-onset neonatal sepsis, delayed presentation, umbilical infection, suspected necrotizing soft-tissue infection, resource-limited settings, case report

Source: International Medical Case Reports Journal

DOI: 10.2147/imcrj.s643149

Authors: Najma Abdifatah Mohamed, Hamdi Abdi Ali

Institution: SIMAD University

Language: English

Topic: Neonatal and Maternal Infections

Subfield: Pediatrics, Perinatology and Child Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,320