What is the diagnosis for a newborn with omphalitis and delayed separation of the umbilical cord without pus?

The diagnosis of leukocyte adhesion deficiency (LAD) is appropriate for a newborn with omphalitis and delayed separation of the umbilical cord without pus. LAD is a primary immunodeficiency that affects the ability of leukocytes (white blood cells) to adhere to the endothelium and migrate out of the bloodstream to sites of infection or inflammation. This impaired adhesion leads to an increased susceptibility to infections, particularly in the neonatal period.

In this context, the characteristic symptoms of omphalitis (infection of the umbilical stump) and delayed separation of the umbilical cord imply a problem with immune function that prevents the effective response to common bacteria in the environment. The absence of pus further suggests that the neutrophilic response is inadequate, which is a hallmark of LAD since the inflammatory cells cannot properly respond to infection.

In newborns, delayed cord separation typically occurs when there is an underlying issue with the immune system, and in the absence of signs of bacterial infection (such as pus), LAD becomes a likely diagnosis. The combination of omphalitis and delayed cord separation without the expected inflammatory response aligns with this immunodeficient state.

Other conditions listed, such as transient hypogammaglobulinemia, cystic fibrosis,