Hidden in the navel: a case of urachal sinus infection in a newborn

IMAGES IN CLINICAL PRACTICE

Hidden in the Navel: A Case of Urachal Sinus Infection in a Newborn

Leonor Aires Figueiredo¹, Ricardo Domingos Grilo², Patrícia Romão², Sónia Antunes³.

¹Pediatric Department, Hospital do Espírito Santo de Évora, Évora, Portugal,
²Pediatric Department, Departamento da Saúde da Mulher e da Criança, Hospital do Espírito Santo de Évora, Évora, Portugal,
³Neonatology Unit, Pediatric Department, Hospital do Espírito Santo de Évora, Évora, Portugal.

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Why this article important?

The authors believe this manuscript is important since it describes a rare case of urachal sinus, where the diagnosis was performed early in life, unlike most reported cases. Urachal anomalies are mostly asymptomatic, with clinical manifestations being related to the underlying anomaly and resulting from the presence of local complications, such as inflammation, infection, umbilical exudate, abdominal pain, or malignancy. The absence of inflammatory signs other than purulent drainage, led to the suspicion of this diagnosis. We believe that these case will be of interest to the readers of your journal, since it will allow them to recognize the symptoms associated with umbilical anomalies, leading to a rapid diagnosis.

Summary of article

Dear editor, This manuscript describes the case of a previously healthy 15-day-old newborn, who presented with umbilical discharge in the absence of other local inflammatory signs or constitutional repercussions. The analytical evaluation did not reveal elevation of inflammatory parameters or other alterations. A Staphylococcus aureus was isolated in the exudate. The absence of inflammatory signs other than the umbilical discharge led to the suspicion of an urachal sinus infection, which was confirmed by ultrasound. He completed 10 days of intravenous flucloxacillin, with complete resolution of the infection. Since then, he has remained asymptomatic under regular imaging control The last imaging evaluation, at 21 months of age, revealed a slight prominence in the vesical aspect of the urachus with no visible communication with the bladder or umbilical region, nor cystic translation.

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