Streptococcus gallolyticus (SG) is an uncommon cause of neonatal infections. We describe the first case of fulminant lethal neonatal sepsis due to SG reported in literature. Our patient was an extremely low birth weight premature infant that was born to a mother with prolonged rupture of amniotic membranes and chorioamnionitis. We also review the cases of neonatal SG infections reported in literature. Fifty-eight percent neonatal SG infections presented in the first week of life. Importantly, SG meningitis is more commonly reported with early-onset infections compared to group B streptococcal meningitis which is more common with late-onset infections. SG must be included in differential for neonatal sepsis, particularly, in presence of meningitis in first week of life. Most cases are sensitive to penicillin, however, cases of reduced sensitivity to penicillin have also been reported.
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