Indications for the Diagnostic Tap of Cephalhematoma: A Survey of Case Reports.
- Author:
Dong Woo SON
;
Hyun Mi LEE
;
Kyu Young KIM
- Publication Type:Case Report
- Keywords:
Cephalhematoma;
Infection;
Diagnosis;
Indication;
Neonate
- MeSH:
Diagnosis;
Electrodes;
Erythema;
Escherichia coli;
Humans;
Infant, Newborn;
Medical Records;
Meningitis;
Osteomyelitis;
Recurrence;
Risk Factors;
Scalp;
Sepsis;
Tomography, X-Ray Computed;
Vacuum
- From:Korean Journal of Perinatology
1998;9(1):50-56
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSES: We experienced a case of infected cephalhematoma drained spontaneously. So we wanted to review the most appropriate method for investigating cephalhematomas for possible infection and to clarify the indications for the diagnostic aspiration. METHODS: MEDLINE searches were conducted for the period from 1972 to 1997, and all reports were obtained. 15 articles reporting 18 infected cephalhematomas were identified in the literature. We analyzed the medical records in patients according to age: sex ; associated infections especially sepsis or osteomyelitis, risk factors such as scalp electrode or vacuum use, local signs such as increase in size, fluctuation, local redness: organisrns: and radiographic findings. RESULTS: Escherichia coli was isolated from over 50% of the cephalhematomas that were aspirated. Most patients presented with sepsis, meningitis, and/or osteomyelitis. Plain radiographs, bone scans, and enhanced CT scans were limited in their ability to determine if a cephalhematoma was infected unless associated osteomyelitis existed. Local signs of scalp infection, such as increase in size, fluctuation, local redness were obvious in almost all cases. CONCLUSIONS: Aspiration is the diagnostic procedure of choice for cephalhematomas suspected of being infected. The indications for aspiration were increase in size, development of erythema, development of fluctuation, relapse of systemic infection, or a delay in the resolution of clinical symptoms of infection.
