Abstract—Reactive arthritis (ReA) is a sterile inflammatory arthritis typically triggered by gastrointestinal or genitourinary infections, with common pathogens including Chlamydia trachomatis and Salmonella. Though rare, urinary tract infections (UTIs) caused by Enterococcus faecalis can also trigger ReA. Diagnosis is clinical, established through a recent infection history and characteristic joint involvement. We present a 61-year-old female with a history of depression and ADHD, who was found in a state of self-neglect and diagnosed with failure to thrive. During hospitalization, she developed symptoms of a UTI, and urine culture grew Enterococcus faecalis. Patient’s symptoms subsequently evolved to include joint stiffness, ocular discharge, and nasal congestion, she was diagnosed with reactive arthritis, likely triggered by her prolonged UTI. The patient was treated and showed improvement throughout her admission. This case highlights the importance of considering reactive arthritis in patients with atypical infectious triggers such as Enterococcus faecalis UTI, especially in the context of prolonged catheterization and persistent infection. Early recognition and appropriate management can improve outcomes. Further research is needed to better characterize the spectrum of pathogens implicated in ReA and to optimize diagnostic and therapeutic strategies.