Xanthogranulomatous pyelonephritis (XPN) is an unusual complication of chronic pyelonephritis typically associated with a large burden of infected and retained kidney stones, a true urologic medical emergency. It is known to occur in middle-aged women experiencing recurrent UTIs. We report upon a case of XPN diagnosed in a 38 year old female residing in an austere area in a South American country with limited access to medical care presenting to the medical unit "COMFORT", a humanitarian mission initiated by the United States Navy with a chief complaint of lower abdominal pain.