Clostridium sordellii necrotizing omphalitis: A case report and literature review

• Clostridium sordellii is a rare cause of omphalitis associated with high mortality.
• Lack of fever, hypotension, edema, and leukocytosis are features of severe infection.
• Early systemic antibiotics and surgical debridement remain the mainstay of treatment.
• No early detection assay or antitoxins are commercially available.

Omphalitis is an infrequent neonatal infection of the umbilicus. Necrotizing infections are a rare complication of omphalitis that requires prompt antibiotic therapy, surgical debridement, and supportive care. Here, we present a rare case of Clostridium sordellii necrotizing omphalitis that progressed to severe toxemia characterized by refractory hypotension, massive capillary leak, leukemoid reaction, and absence of fever. These clinical features are common in C. sordellii infections and harbor a poor prognosis with only one reported survivor (out of 12) of C. sordellii omphalitis reported in the literature. Early antibiotic and surgical intervention remain the mainstay of care as no early detection assays or antitoxins are commercially available.