Non-typhoidal salmonella: an unusual cause of spontaneous bacterial peritonitis in decompensated cirrhosis

Salmonella typhimurium, a non-typhoidal salmonella, is an unusual cause of spontaneous bacterial peritonitis (SBP). It is usually reported in asymptomatic patients with normal or high ascitic fluid protein levels with underlying immunosuppression, as high opsonic activity in the ascitic fluid of these patients protects them from the usual organisms causing spontaneous bacterial peritonitis, unless they are exposed to a particularly virulent organism like salmonella. We report a case of culture-proven non-typhoidal salmonella in a patient with decompensated cirrhosis, with low protein and without any underlying immunosuppression, and no other source to explain its origin.