Early-Onset Neonatal Sepsis Caused by Globicatella sanguinis/sulfidifaciens : Case Report.

Background Globicatella sanguinis is a rare α-hemolytic gram-positive coccus increasingly recognized as a human pathogen but remains an uncommon cause of neonatal invasive infection. Reported neonatal cases are limited, and optimal antimicrobial therapy is uncertain because Clinical and Laboratory Standards Institute (CLSI) susceptibility breakpoints are unavailable. Case Presentation A term female neonate born at 39 3/7 weeks via vacuum-assisted vaginal delivery after an in vitro fertilization pregnancy developed respiratory distress and lethargy shortly after birth. Delivery was complicated by umbilical cord avulsion, causing acute blood loss and hypovolemia. Initial evaluation demonstrated metabolic acidosis, leukocytosis, bandemia, and a rapid hematocrit decline requiring packed red blood cell transfusion. Blood culture obtained at birth grew Globicatella sanguinis/sulfidifaciens within 12 hours, whereas cerebrospinal fluid culture remained sterile. Empiric ampicillin and gentamicin were initiated; repeat blood cultures were negative. Susceptibility testing yielded minimum inhibitory concentration values without CLSI interpretation. Following infectious disease consultation, the infant completed a 10-day course of intravenous ampicillin from the first negative blood culture and recovered without complications. Conclusion This case highlights the diagnostic overlap between hemorrhagic shock and early-onset neonatal sepsis and emphasizes the management challenges posed by rare pathogens lacking standardized susceptibility criteria and evidence-based neonatal treatment recommendations.