Case Report: A neonatal case of Elizabethkingia anophelis sepsis complicated by meningitis and intestinal necrosis: a triumph of multidisciplinary management.

This case reports a 10 day old neonate with fulminant Elizabethkingia anophelis sepsis presenting as disseminated infection involving meningitis and intestinal necrosis. Pathogen identification was achieved on hospital day 2 by metagenomic next generation sequencing and confirmed by blood and cerebrospinal fluid cultures, enabling antimicrobial susceptibility guided therapy. The infant was treated with cefoperazone sulbactam plus levofloxacin on day 3, switched to levofloxacin plus trimethoprim sulfamethoxazole (TMP SMX) on day 10, and stepped down to oral TMP SMX on day 24, completing a 42 day course (24 days intravenous and 18 days oral). Concurrently, three surgical interventions, including bowel resection, burr hole drainage, and Ommaya reservoir placement, were performed to address intestinal perforation and intracranial complications. At 4 months of corrected age, the infant showed age appropriate neurodevelopment with no recurrence or sequelae. This successful outcome underscores that prompt diagnostics, susceptibility driven antibiotic optimization, and a coordinated multidisciplinary surgical medical approach are essential for managing life threatening neonatal Elizabethkingia anophelis infections, even in the setting of severe multisystem involvement.