Salmonella species bacteria are waterborne and foodborne pathogens that affect the gastrointestinal tract. They do not usually affect the urinary collecting system and cause renal abscess. Salmonella infection causing renal abscess is rare. Risk factors can include urinary structural abnormalities, urolithiasis and immunocompromised states. Clinical symptoms can include fever, dysuria, urinary frequency and renal angle tenderness.

We describe a 19-year-old male who developed urosepsis and left renal abscess secondary from Salmonella Mississippi infection. This patient had swum in a nearby dam 1 week before presentation. Salmonella Mississippi is found in native Australian wildlife and in untreated drinking water. They presented to our hospital with fever, lethargy, rigors, and malodorous urine. The patient’s past medical history includes Eczema for which they take Dupilumab.

Our patient initially required vasopressor support in ICU. They were treated with broad spectrum intravenous antibiotics. A CT scan demonstrated a 43 x 38 x 24 mm left renal abscess. An ultrasound guided percutaneous drain was inserted into the abscess. Abscess culture confirmed presence of Salmonella Mississippi. This bacterium was also present on stool and blood cultures. The patient made a good recovery and on day 7 the drain was removed. Serial scans via CT and ultrasound confirmed resolution of the abscess. The patient was asymptomatic and had no abscess at the 2-month follow-up.

We concluded that our patient contracted this infection from swimming in contaminated waters. The bacteria must have then infected the gastrointestinal tract and infected the left kidney via haematogenous spread. Our patient was successfully managed with intravenous broad-spectrum antibiotics and ultrasound guided percutaneous drainage of the abscess.