Neonatal Necrotizing Fasciitis of the Foot Caused by Bacillus cereus: A Case Report.

Few neonatal cases of soft tissue and osteoarticular infections with Bacillus cereus have been reported. We report a rare clinical presentation of necrotizing fasciitis of the foot caused by B. cereus in a 17-day-old male neonate with hypoplastic left-sided heart syndrome. Fulminant progressive black skin necrosis was triggered by fresh frozen plasma leakage from the peripheral venous access. This patient was treated with antibacterial agents as soon as skin lesions appeared, and the necrotic tissue was debrided in 48 hours. The patient recovered after three months of hospitalization without any subsequent complications in the 3.5 years of follow-up. The immune system is not fully developed at birth, resulting in high susceptibility of neonates to B. cereus systemic infection. When a neonate presents with a rapidly progressive necrotizing soft tissue infection, B. cereus should be considered as the possible cause and treated promptly.