International Journal of Contemporary Pediatrics | December 2020 | Vol 7 | Issue 12 Page 2391 International Journal of Contemporary Pediatrics Sonaiya S et al. Int J Contemp Pediatr. 2020 Dec;7(12):2391-2393 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Case Report Patent urachus with methicillin-resistant coagulase negative staphylococcal sepsis in a 23 days old neonate Sneh Sonaiya*, Shivani Chaudhary INTRODUCTION An embryological remnant of the allantois, urachus, is a transverse structure lying between the peritoneum and the fascia transversalis. As the urinary bladder descends towards the pelvis, it stretches the urachus, causing the obliteration of the lumen. 1 This obliteration takes place with the increasing gestational age. However, partial or complete failure of the obliteration of the lumen of urachus is not uncommon. Failure of complete obliteration of the urachus, which is reported to be present in approximately 30% of adults, can lead to several abnormalities of the urachus. Urachal anomalies are commonly present as pain over the abdomen or sepsis in the umbilical region. There are four types of congenital urachal remnant anomalies. 2 They are: patent urachus: a communication between the bladder and umbilicus through a urachus that has not involuted, urachal cyst: a fluid-filled dilatation of the mid urachus, umbilical-urachal sinus: blind focal dilatation of the umbilical end of the urachus and vesicourachal diverticulum: blind focal dilatation of the bladder end of the urachus. CASE REPORT A 23-day old female neonate, delivered at full term on 26 th March 2020 with a birth weight of 2.8 kg, presented to us with complaints of fever for 11 days and umbilical discharge for 4 days. The patient was receiving outpatient department (OPD) based medications for fever from a private hospital and later on developed redness around the umbilicus for 4 days before presentation. Clinical findings On clinical examination, a 2×2 cm 2 size swelling was present around the umbilicus along with redness around the umbilicus and low-grade fever. There was a yellowish ABSTRACT A remnant of the umbilical arteries, urachus, is a transverse structure lying between the peritoneum and the fascia transversalis. Urachus results from the involution of the embryonic duct and the ventral cloaca. The Urachus drains the bladder of the fetus by running within the umbilical cord. Usually, during embryonic development, the urachal tract obliterates. Failure of complete obliteration of the urachus, which is reported to be present in approximately 30% of adults, can lead to several abnormalities of the urachus. Common abnormalities of the urachus include - urachal cyst, diverticulum, umbilical sepsis, or patent urachus. This is a case report of a 23 days old female neonate who presented to us with complaints of fever for 11 days and umbilical discharge for 4 days. Clinical, microbiological, and radiological examinations revealed patent urachus with Methicillin-resistant coagulase-negative staphylococcal (MR-CoNS) umbilical sepsis. It is a rare condition that requires management with higher antibiotics based on culture and sensitivity tests. Keywords: Patent urachus, Umbilical sepsis, MR-CoNS Department of General Surgery, Government Medical College Baroda and S. S. G. Hospital, Vadodara, Gujarat, India Received: 16 September 2020 Revised: 03 November 2020 Accepted: 12 November 2020 *Correspondence: Dr. Sneh Sonaiya, E-mail: snehsonaiya123@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20205103