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Necrotizing enterocolitis (NEC) is most often a disease of preterm infants, but can develop in full term infants with gastroschisis. The latter cases typically present later and have a milder clinical course; we present the first case of fatal Clostridium perfringes-associated NEC in a full term infant with gastroschisis. Our case highlights the need for a high index of clinical suspicion for Clostridial NEC when there is rapid progression of disease and/or evidence of hemolysis. When Clostridial NEC is suspected, we recommend treatment with penicillin G and clindamycin, as well as prompt, aggressive surgical intervention.