# A Rare Case of Neonatal Escherichia coli Conjunctivitis With Maternal Asymptomatic Bacteriuria

## TL;DR

A preterm infant developed E. coli conjunctivitis, highlighting the need for early diagnosis and awareness of emerging neonatal infections.

## Contribution

This case report emphasizes E. coli as an emerging cause of neonatal conjunctivitis and the importance of maternal history in diagnosis.

## Key findings

- E. coli conjunctivitis occurred in a preterm infant during NICU stay.
- Maternal asymptomatic bacteriuria may contribute to neonatal E. coli infections.
- Early diagnosis requires considering atypical pathogens like E. coli in neonates.

## Abstract

Escherichia coli is an uncommon but increasingly recognized pathogen in neonatal infections, including conjunctivitis. We report a case of a preterm male infant born at 34 weeks of gestation who developed E. coli conjunctivitis during his neonatal intensive care unit (NICU) stay. This case underscores the importance of considering E. coli as an emerging cause of neonatal conjunctivitis, particularly in preterm infants. It also highlights the critical role of thorough maternal history review, including recent infections, colonization, and obstetric complications, in guiding early diagnosis and targeted management. As antibiotic resistance patterns evolve and maternal colonization with Gram-negative organisms becomes more prevalent, clinicians must maintain a high index of suspicion for atypical pathogens in neonatal infections.