Purple Urine Bag Syndrome in Urinary Tract Infection

Abstract

Purple urine bag syndrome (PUBS) is an unusual manifestation of urinary tract infection, characterized by purple discoloration of urine. Due to its rarity, it can be challenging for some physicians to manage it properly. In addition, its striking appearance can cause concern to some patients. This condition usually occurs in the debilitated geriatric population with prolonged use of an indwelling urinary catheter. However, our case highlights the development of PUBS in a young adult with a relatively short period of urinary catheterization.

A Peculiar Manifestation of Urinary Tract Infection in a 76-year-old Female

“…2,11,12 The indoxyl, in the alkaline urine, will be oxidized into indigo (blue pigment) and indirubin (red pigment), which will mix and react with the urinary catheter bag, producing purple colour. 13 However, PUBS has also been encountered in patients with acidic urine. A high bacterial load is needed to precipitate PUBS.…”

“…Aside from the sulphatase and phosphatase-producing bacteria, some predisposing factors must be present to develop PUBS. 6,13 Patients with long-term urinary catheter usage, constipation, dementia, alkaline urine, dehydration, and female gender are at risk of developing PUBS. 4,13,14 A high bacterial load in the urine combined with these factors facilitates the development of PUBS and increases the availability of bacterial sulphatases and phosphatases.…”

“…6,13 Patients with long-term urinary catheter usage, constipation, dementia, alkaline urine, dehydration, and female gender are at risk of developing PUBS. 4,13,14 A high bacterial load in the urine combined with these factors facilitates the development of PUBS and increases the availability of bacterial sulphatases and phosphatases. A previous study reported PUBS prevalence was 8.3-16.7% in patients using a long-term indwelling catheter.…”