BMJ Case Reports 2017; doi:10.1136/bcr-2017-222187
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Urachal sinus leading to pyourachus presenting as recurrent periumbilical sepsis in an infant

  1. Harshawardhan Bilolikar2
  1. 1Department of Radiology, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Department of Paediatrics, Kettering General Hospital NHS Foundation Trust, Kettering, UK
  3. 3Radiology, Kettering General Hospital, Kettering, UK
  1. Correspondence to Dr Ken-win To,{at}
  • Accepted 29 October 2017
  • Published 12 November 2017


A 5-month-old female infant presented with an 8 days duration of fever and irritability. In the previous 48 hours, she developed a rash around her umbilicus with reduced feeding and wet nappies (figure 1). She was born at 38+3/40 weeks gestation by caesarean section for breech presentation. At 4 months of age, she had gastro-oesophageal reflux. She initially presented to the general practitioner (GP) at 3 months of age with redness around the umbilicus and dried clots in the centre without any swelling. She had no fever and was otherwise well. Initial treatment given by GP included a 1-week course of oral flucloxacillin for provisional diagnosis of infected umbilical granuloma. …

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