Neonatal meningitis by Cupriavidus pauculus: A rare pathogen with suspected vertical transmission

We report Cupriavidus pauculus meningitis in a preterm neonate, likely vertically transmitted. The mother, at 33 + 6 weeks, had severe pneumonia and ARDS, requiring ICU admission and emergency C-section. The 1641g neonate developed early respiratory distress, followed by apnea and lethargy by day 6. CSF confirmed bacterial meningitis, initially misidentified as Pseudomonas; VITEK-2 identified C. pauculus. This first possible vertical transmission and second reported neonatal meningitis case highlights diagnostic challenges. MALDI-TOF may misidentify rare pathogens due to protein overlap and limited spectra. VITEK's biochemical profiling improves accuracy; combining identification methods and retesting enhances diagnostic reliability.