Background: Pseudescherichia vulneris is a rare pathogen associated with infections in immunocompromised adults. This may be the first documented report of a neonate with late-onset sepsis.

Case Report: An 18-day-old term baby was admitted to the pediatric unit with a five-day history of fever and refusal to feed. The infant was irritable, jaundiced, and pale. Notably, the mother experienced prolonged premature rupture of membranes (PROM). Blood culture isolated multi-drug-resistant P. vulneris and Acinetobacter baumannii. Identifying the organism was challenging due to its rarity, phenotypic similarity to other Enterobacteriaceae, and limited access to advanced diagnostic tools. The treatment was successful, as the baby responded well to antibiotics and was discharged.

Conclusions: This case highlights the potential for rare pathogens to cause neonatal sepsis, the challenges in diagnosing such infections in resource-limited settings, and the risk of multidrug-resistant strains emerging in the isolate. The case also underscores the necessity for further research to elucidate the pathogenesis, epidemiology, and optimal management of P. vulneris infections.