Salmonella typhi: The Story beyond Typhoid

Background: Urinary Tract Infections (UTIs) caused by Salmonella typhi are rare, but there are a few reports of bacteria in urine from nontyphoidal Salmonellae and other Gram-negative bacilli. However, cases of bacteriuria with UTI due to nontyphoidal Salmonellae were more frequently reported in the past among individuals having urolithiasis. Case Study: We, herein, report a case of Salmonella Typhi bacteriuria with urolithiasis in a woman aged 35 years who has a poor socio-economic background and comes from the rural belt of western Nepal with inadequate and hygienically unsatisfactory drinking water facilities. Results: The woman's multiple episodes of vaginal bleeding led to an abdominal and pelvic ultrasound, which revealed several renal stones. The tests on both the stone and urine sample showed the presence of Salmonella typhi, and they reacted the same way to antibiotics. Conclusion: Our report highlighted the association of renal stones with urinary excretion of Salmonella typhi. Isolation of the organism from the crushed-out material of the renal stone as well as from the urine could suggest the persistence of the organism in the stone matrix being excreted from time to time, giving rise to intermittent bacteriuria. Based on the clinical, imaging, and lab results in this case, we are trying to understand how Salmonella typhi can stay in the body without causing symptoms.