Title: Abdominal Wall Necrotizing Fasciitis in a Preemie: A Case Report of a Fulminant Course

Necrotizing fasciitis (NF), a rapidly progressive soft-tissue infection characterized by extensive tissue necrosis, is a fulminant condition that, if not treated promptly, can become fatal. Predominantly a disease of adulthood, its occurrence in the pediatric and neonatal populations is rare. We report a case of a preterm newborn who developed NF of the abdominal wall due to the rare etiology of invasive Klebsiella pneumoniae in the setting of culture-proven sepsis secondary to ventilator-associated pneumonia. This case highlights the challenges of early recognition and management in unstable preterm neonates with rapidly progressive infections, in whom a fatal outcome could not be avoided despite timely and intensive management efforts.