Young infant with umbilical protrusion

A 1-month-old male infant presented to a pediatric emergency department with a fever and poor activity. Physical examination revealed tachycardia, slightly mottled skin, abdominal distension, and an umbilical protrusion (Figure 1).

The symptom of umbilical protrusion raised the suspicion of a HPeV3 infection, polymerase chain reaction was performed, and HPeV was detected in the cerebrospinal fluid. A type analysis revealed HPeV3. His general condition, including the umbilical protrusion, resolved after a few days.

HPeV3 can cause a severe infection, such as sepsis or a central nervous system infection, in a young infant.¹ Early diagnosis, though difficult, can enable the discontinuation of unnecessary antibiotic therapy and help predict the clinical course of the infection.

Umbilical protrusion is one of the characteristic symptoms of early infantile HPeV3 infection. In a previous study, eight of 43 young infants with HPeV3 (19%) presented with an umbilical protrusion.² Umbilical protrusion is typically observed in the presence of abdominal distention.³ Abdominal distension caused by HPeV3 is sometimes severe and may be confused with a surgical condition.⁴ The mechanism of umbilical protrusion is thought to be an increased abdominal pressure and the insufficient development of the umbilical ring in young infants. In young infantile cases of abdominal distention and umbilical protrusion accompanied by sepsis-like symptoms, HPeV3 should be considered in a differential diagnosis.

The authors declare no conflicts of interest.

There were no sources of funding for this study.