Salmonella typhimurium infection after lingual mucosa graft ureteroplasty: a case report and review of literature

Salmonella, a major foodborne pathogen, significantly contributes to global diarrheal diseases. Following infection, the primary manifestation often involves the development of acute gastroenteritis, with only a small subset of serotypes capable of precipitating severe systemic illness, marked by fever, sepsis, or miscarriage. Detailed case reports focusing specifically on urinary tract infections caused by Salmonella Typhimurium have not been documented. A 49-year-old Chinese female presented with significant upper ureteral stricture, with a visible narrow segment of about 3 cm in length on retrograde pyelography. The decision was made to proceed with robotic ureteroplasty with a lingual mucosa graft. Eleven days postoperatively, the patient developed recurrent fever. Bacterial culture of mid-stream urine detected Salmonella typhi twice and Escherichia coli once.The patient was treated with cefoperazone/sulbactam and meropenem successively. Fifty days after surgery, double-J stent removal was performed, and the patient remained afebrile thereafter. This case suggests that urinary tract infection may not be the most crucial factor influencing the survival of autologous tissue grafts. With aggressive antimicrobial therapy according to sensitivity, the survival of autologous tissue grafts remains unaffected. Our case may offer valuable insights on urinary tract infections in the context of autologous tissue transplantation for ureteral augmentation.