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

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.