We report the case of a five-month-old infant who presented with progressive irritation for ten days.
Separate vomiting, no fever, or urine or stool changes
In recent days, the patient complained of abdominal discomfort and, on the same day as the consultation, presented with an exudative purulent discharge from the primary care clinic.
This was a full-term newborn with an adequate weight for gestational age.
She had a controlled pregnancy, without risk factors for infection.
The neonatal period was uneventful.
Omphalorrhexis stands out at 14 days of life, with a small residual granuloma that required cauterization with nitrate dexamethasone on two occasions.
There was no history of moist wound infection.
Upon arrival at the Emergency Department, physical examination revealed a red tumour with spontaneous voiding of pus in the obscure.
The adjacent area was erythematous and distended, without other inflammatory signs.
The rest of the examination was normal.
Vital signs were: temperature 36.1 °C, heart rate 139 bpm, blood pressure 98/51 mmHg and oxygen saturation 100% in room air.
1.
An analytical control with blood count showed leukocytosis with normal and biochemical formula with C-reactive protein (CRP) of 44 mg/l.
Antibiotic treatment with cloxacillin and umbilical exudate was initiated.
An abdominal ultrasound was performed 24 hours after admission, showing adjacent to the upper bladder area towards the infected urachus heterogeneous collection 5.5 × 2.5 × 2.4 cm, with a diagnosis of probable cyst.
Subsequently, Staphylococcus aureus was isolated in culture, maintaining treatment with cloxacillin with good evolution, disappearance of inflammatory signs and purulent secretion.
She was discharged six days after admission, with follow-up by Pediatric Surgery.
