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Vol 12, No 4 (2018)
Case report
Published online: 2019-01-21
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Purple Urine Bag Syndrome in Palliative Care : Case Report

Aleksandra Maslowska1, Miłosz Gromelski2, Gabriela Picco3, Isabel Erquiaga3
DOI: 10.5603/PMPI.2018.0014
·
Palliat Med Pract 2018;12(4):214-217.
Affiliations
  1. Uniwerytet Medyczny, Al. Kściuszki 4, Łódź, Poland
  2. Krakowski Szpital Specjalistyczny im. Józefa Dietla, Kraków, Poland
  3. Hospital San Juan de Dios, Calle Beloso Alto 3, 31006 Pamplona, Spain

open access

Vol 12, No 4 (2018)
Case report
Published online: 2019-01-21

Abstract

The purple urine bag syndrome (PUBS ) is a rare phenomenon consisting of a urine discolouration in patients with long term urinary catheterization who develop urinary tract infection. The main risk factors are: elderly age, female sex, chronic constipation, alkaline urine with high bacterial levels and bedridden status. It occurs when the product of the amino acid tryptophan is metabolized to indoxyl sulfate. This substance due to bacterial enzyme reactions and in the alkaline environment gets oxygenized to indigo (blue) and indirubin (red), which precipitate in the urine and on to the synthetic material of the urinary catheter and urine bag, resulting in the characteristic purple color. We present a case of an 85-year-old woman who was deteriorating from advanced cancer (colon cancer with liver cirrhosis) who developed purple urine bag syndrome.

Abstract

The purple urine bag syndrome (PUBS ) is a rare phenomenon consisting of a urine discolouration in patients with long term urinary catheterization who develop urinary tract infection. The main risk factors are: elderly age, female sex, chronic constipation, alkaline urine with high bacterial levels and bedridden status. It occurs when the product of the amino acid tryptophan is metabolized to indoxyl sulfate. This substance due to bacterial enzyme reactions and in the alkaline environment gets oxygenized to indigo (blue) and indirubin (red), which precipitate in the urine and on to the synthetic material of the urinary catheter and urine bag, resulting in the characteristic purple color. We present a case of an 85-year-old woman who was deteriorating from advanced cancer (colon cancer with liver cirrhosis) who developed purple urine bag syndrome.

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Keywords

purple-urine-bag-syndrome; urine-discolouration; urinary-tract-infection; bedbridden-status; Palliative-care

About this article
Title

Purple Urine Bag Syndrome in Palliative Care : Case Report

Journal

Palliative Medicine in Practice

Issue

Vol 12, No 4 (2018)

Article type

Case report

Pages

214-217

Published online

2019-01-21

Page views

1562

Article views/downloads

12536

DOI

10.5603/PMPI.2018.0014

Bibliographic record

Palliat Med Pract 2018;12(4):214-217.

Keywords

purple-urine-bag-syndrome
urine-discolouration
urinary-tract-infection
bedbridden-status
Palliative-care

Authors

Aleksandra Maslowska
Miłosz Gromelski
Gabriela Picco
Isabel Erquiaga

References (5)
  1. Wattanapisit S, Wattanapisit A, Meepuakmak A, et al. Purple urine bag syndrome in palliative care. BMJ Support Palliat Care. 2018 [Epub ahead of print].
    CrossRefPubMed
  2. Traynor BP, Pomeroy E, Niall D. Purple urine bag syndrome: a case report and review of the literature. Oxf Med Case Reports. 2017; 2017(11): 2015–2017.
    CrossRefPubMed
  3. Al Montasir A, Al Mustaque A. Purple urine bag syndrome. J Family Med Prim Care. 2013; 2(1): 104–105.
    CrossRefPubMed
  4. Pandey S, Pandey T, Sharma A, et al. Purple urinary bag syndrome: what every primary healthcare provider should know. BMJ Case Rep. 2018; 2018.
    CrossRefPubMed
  5. Karray O, Batti R, Talbi E, et al. Purple urine bag syndrome, a disturbing urine discoloration. Urol Case Rep. 2018; 20: 57–59.
    CrossRefPubMed

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