Salt Treatment for Umbilical Granuloma - An Effective, Cheap, and Available Alternative Treatment Option: Case Report

Abstract

Introduction: Umbilical granuloma (UG) is the most common cause of umbilical mass and it is formed in the first few weeks of life after the umbilical cord separates. Though there are different options of treatment described in the literature, there is no clear consensus on the best option of treatment. In our case, we will describe the complete resolution of granuloma with salt treatment with no adverse effect.

Case presentation: An 18-day-old female infant presented to the outpatient department (OPD) with concerns of swelling over the umbilicus with a yellowish discharge of one-day duration noticed after separation of the umbilical cord. The discharge was, initially, odorless, with no fecal or urine content, no pain, and behavioral change in the neonate. The mother was advised on sponge wash and to apply silver nitrate or liquid nitrogen. After five days, the patient presents with purulent discharge from the umbilical swelling of two-day duration but no other complaint. Discharge was noted to be purulent but no erythema in the surrounding skin. The patient had no leukocytosis on labs. A teaspoon of cooking salt was applied to cover the whole granuloma and packed the umbilicus for 30 minutes with gauze. After 30 minutes on the pack, the salt was removed and cleaned with normal saline. Subsequently, after the salt was applied, the granuloma changed from red to blush hue. After three applications of salt pack, the granuloma decreased in size, became dry, and separated. There was no side effect noted and the infant was followed up with no recurrence noted at 3 months of age.

Conclusion: Salt treatment appears to be an effective, available, and less costly treatment option for an umbilical granuloma.

Keywords: granuloma; neonate; salt; umbilicus.

Figure 1

The Initial appearance of umbilical granuloma with a yellowish discharge at its base after the cord falls off.

Figure 2

Infected umbilical granuloma with pussy discharge, but no erythema of the surrounding skin.

Figure 3

The immediate color change of Umbilical granuloma after salt was applied and packed for 30 minutes.

Figure 4

Umbilical granuloma changes in the subsequent salt application. (A) After the salt was applied for a second time. (B) After the salt was applied for the third time.