Previous studies have reported the isolation of Escherichia coli and Proteus mirabilis from urine samples (1-3). In the present study, we successfully isolated capnophilic P. mirabilis capable of producing extended-spectrum β-lactamase (ESBL), a causative agent of acute pyelonephritis. In addition, the isolate was not capable of growing in modified Drigalski (BTB) (Kyokuto Pharmaceutical Ind., Tokyo, Japan) and or MacConkey agar media (Eiken Chemical Co., Ltd., Tokyo, Japan). The patient was an octogenarian Japanese male suffering from urinary tract infection with a body temperature ranging from 38 C to 40 C. The patient was admitted in June 2016 to Nakatsugawa Municipal General Hospital, Nakatsugawa, Japan because of fever (38.5 C). The ethical committee waived the need for written consent regarding the research of bacterial isolates; the personal data related to the clinical information were anonymized. Direct microscopy of the