Introduction: Spontaneous bacterial peritonitis (SBP) is a common infection seen in cirrhotic patients, with bacterial translocation as a major mechanism of pathogenesis. Salmonella typhimurium is a gram negative non-typhoidal bacteria, which has been reported as an unusual cause of SBP in immunocompromised patients. We report a rare case of a salmonella empyema secondary to SBP in a decompensated cirrhotic. Case Report: A 63 year old Caucasian male with a history of cirrhosis secondary to chronic hepatitis C virus (HCV) was admitted with ascites and leukocytosis (WBC of 25.9 x109 per liter). Paracentesis revealed a WBC of 1196 (39% PMN's), consistent with a diagnosis of SBP. The patient was admitted and treated with intravenous albumin and antibiotics. Gram stain and culture of the ascitic fluid were negative. He clinically improved and was discharged on oral antibiotics after three days of hospitalization. Approximately one week later, the patient returned to the emergency department with progressive shortness of breath. He was hypoxic and had a significant leukocytosis (WBC of 19 x109 per liter). His abdominal exam was benign without any reoccurrence of ascites, but chest imaging demonstrated a right sided pleural effusion (Image 1 and Image 2). Thoracentesis was performed, which was consistent with an empyema. Gram stain of the pleural fluid showed gram negative rods and cultures grew non-typhoidal salmonella typhimurium (Image 3). Discussion: Non-typhoidal Salmonella is a rare cause of SBP that has been previously reported in the literature. Published case reports show an association of SBP with immunocompromised states such as malignancy, chemotherapy and organ transplant recipients. While a few cases of nontyphoidal Salmonella empyemas have been seen in the literature, this is the first reported case of SBP implicated as the cause of a Salmonella empyema. While a rare pathogen, Salmonella should be recognized as a cause of SBP in decompensated cirrhosis, especially in patients who are immunocompromised.