Year: 2026
Type: article
Study design: Case Report
Abstract: grew 10³-10⁴ C. tuberculostearicum, which was resistant to ceftriaxone (MIC >2), meropenem (MIC >8), and penicillin (MIC >8) but sensitive to vancomycin (MIC <1), identified by matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) and wholegenome sequencing at Mayo Clinic Laboratories.Ultrasound of the IntroductIonNeonatal urinary tract infections (UTIs) typically present primarily with fever and, depending on severity, can also present with some nonspecific symptoms including lethargy, poor feeding, or vomiting.The most common pathogens associated with neonatal UTIs include Escherichia coli, Enterococcus, and Klebsiella species. 1 In this case, we present an uncommon presentation of neonatal UTI caused by a rare pathogen in the neonatal population. case descrIptIonA female infant was born at 28 weeks' gestation with a birth weight of 750 gm and was admitted to the neonatal intensive care unit (NICU).Prenatal history was significant for first-trimester alcohol use and intrauterine growth restriction; however, other maternal lab tests for infectious diseases were negative.Initial sepsis evaluation, including blood cultures drawn on day of life (DOL) 1, was negative after 48 hours.The patient empirically received 48 hours of ampicillin and gentamicin.The NICU course was complicated by multifocal colonic perforations, which required resection and ileostomy.The patient was initially treated with piperacillintazobactam as well as prophylactic fluconazole.At approximately 8 weeks of life, the patient developed poor feeding, suboptimal weight gain, and a fussy appearance.This was followed by increased desaturations, increased ostomy output, and cloudy, foul-smelling urine; therefore, sepsis evaluation was initiated and infectious disease was consulted.Most recent labs were notable for thrombocytopenia and a left shift.Antibiotics were switched to cefotaxime and fluconazole.At the time of evaluation, the patient was afebrile, with vital signs otherwise within normal limits.Physical exam was remarkable for a fussy but consolable appearance, with otherwise normal findings.Urinalysis obtained by straight catheterization was significant for cloudy appearance (Fig. 1), positive leukocyte esterase, 100 protein units, moderate bacteria, >100 red blood cells (RBC), and >50 white blood cells (WBC) per high-powered field.Urine culture obtained via straight catheterization grew 10³-10⁴ gram-positive bacilli, later identified as Corynebacterium species.A subsequent urine culture a few days later, obtained via straight catheterization,
Source: Pediatric Infectious Disease
Authors: Valerie Lim, Stephen C Eppes
Institution: Christiana Hospital
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7155504961