From the Research
The best investigation of umbilical discharge is a thorough clinical assessment followed by ultrasonography, as recommended by the most recent study 1. This approach allows for the identification of potential underlying abnormalities such as urachal remnants, omphalomesenteric duct remnants, or abscess formation. The clinical assessment should include a thorough medical history and physical examination to identify signs of infection, such as erythema, edema, and tenderness. Key points to consider in the investigation of umbilical discharge include:
- Obtaining a swab culture of the discharge to identify potential pathogens, particularly looking for Staphylococcus aureus, Streptococcus species, and gram-negative bacteria 2
- Using ultrasonography as the initial diagnostic modality to evaluate for underlying abnormalities, with CT or MRI considered in persistent cases to better visualize deeper structures 1, 3
- Considering blood tests, including complete blood count and C-reactive protein, to assess the severity of any infection 2
- Initiating empiric antibiotic therapy while awaiting culture results, with options including amoxicillin-clavulanate or cephalexin 2 The most recent and highest quality study 1 supports the use of ultrasonography as the initial diagnostic modality, followed by surgical excision in cases with persistent umbilical disorders. It is essential to note that umbilical discharge often results from poor hygiene, infection, or anatomical abnormalities, making accurate diagnosis crucial for appropriate management 2, 1, 3.