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Lima JVF, da Costa MDS, Cavalheiro S. "The blue catheter" - case report. Childs Nerv Syst 2024; 40:1949-1951. [PMID: 38427107 DOI: 10.1007/s00381-024-06330-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/21/2024] [Indexed: 03/02/2024]
Abstract
The ventriculoperitoneal shunt placement procedure is common throughout the world, with a prevalence of approximately 30,000 procedures per year in the United States (5). However, the rate of complications is still important and must be remembered, with a percentage of 11 to 25% after the first year of implantation. Abdominal complications are described in 5-47% of the cases (6), and the abdominal pseudocyst is one of them. We present the case of a patient colonized by multidrug-resistant bacteria, who underwent exteriorization surgery of a ventriculoperitoneal shunt. Intraoperatively, a blue coloration was observed in the catheter, a phenomenon previously described in urinary infections (1)(2) but not before in pathologies of the central nervous system. Our objective is to present an atypical case of dysfunction of the ventriculoperitoneal shunt, whose diagnosis couldbe evidenced through the coloration of the catheter exteriorized in surgery.
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Affiliation(s)
- J V F Lima
- Federal University of São Paulo, São Paulo, Brazil.
| | | | - S Cavalheiro
- Federal University of São Paulo, São Paulo, Brazil
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2
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Julião M, Cruz M. The color purple: Purple urine bag syndrome: Identifying the phenomenon to ease unnecessary anxiety, fear, and distress. Palliat Support Care 2024; 22:424-426. [PMID: 37435644 DOI: 10.1017/s1478951523000949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
OBJECTIVES Purple urine bag syndrome (PUBS) is a condition that causes an intense purple discoloration of the urine, predominately in frail, dependent, and bedridden persons who are chronically catheterized and have urinary tract infections. Despite being considered a benign syndrome, PUBS can cause great anxiety, fear, and distress in health professionals, chronically ill persons, and caregivers or family members who provide care. METHODS We report the case of a 98-year-old institutionalized woman with Alzheimer's dementia with a long-term urinary catheter who developed PUBS. RESULTS Although alarming and distressing for the resident and the health-care team, PUBS was resolved by treating the underlying urinary tract infection and applying good genital hygiene and catheter replacement. SIGNIFICANCE OF RESULTS Identifying PUBS and its clinical features and management proved to be significantly helpful in ameliorating the anxiety, fear, and distress around the phenomenon.
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Affiliation(s)
- Miguel Julião
- Equipa Comunitária de Suporte em Cuidados Paliativos de Sintra, Sintra, Portugal
- Inválidos do Comércio IPSS, Lisboa, Portugal
| | - Mário Cruz
- Inválidos do Comércio IPSS, Lisboa, Portugal
- Escola de Psicologia e Ciências da Vida, Universidade Lusófona, Lisboa, Portugal
- USF Tapada, ACeS Sintra, Sintra, Portugal
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3
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Kaplan G, Seferoğlu Z, Berdnikova DV. Photochromic derivatives of indigo: historical overview of development, challenges and applications. Beilstein J Org Chem 2024; 20:228-242. [PMID: 38352070 PMCID: PMC10862137 DOI: 10.3762/bjoc.20.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 01/23/2024] [Indexed: 02/16/2024] Open
Abstract
The importance of indigo dyes is constantly increasing with the evolution of novel textile materials and photochromic material technologies. The aim of this review article is to provide a comprehensive overview of the development of photochromic indigo derivatives from the first report on the photochromic N,N'-diacetylindigo in 1954 until now. We begin with the list of historical milestones in the development of photochromic indigo derivatives. Further, we provide a brief description of the synthetic procedures utilised to obtain indigo and its derivatives, outline the structural peculiarities, photophysical and photochemical properties of indigo and proceed with the detailed discussion of the photochromic indigo derivatives. Finally, we highlight the photochromism of the structural isomers of indigo (isoindigo and indirubin) and provide an overview of prospective applications of indigo photoswitches.
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Affiliation(s)
- Gökhan Kaplan
- Department of Chemistry, Faculty of Science, Gazi University, Yenimahalle, Ankara, 06560, Turkey
- Sanko Tekstil İşletmeleri, Sanayi ve Ticaret A.Ş. Isko Sb, Bursa, 16400, Bursa, Turkey
| | - Zeynel Seferoğlu
- Department of Chemistry, Faculty of Science, Gazi University, Yenimahalle, Ankara, 06560, Turkey
- Organische Chemie II, Universität Siegen, Adolf-Reichwein-Str. 2, 57076 Siegen, Germany
| | - Daria V Berdnikova
- Organische Chemie II, Universität Siegen, Adolf-Reichwein-Str. 2, 57076 Siegen, Germany
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4
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Joyce SA, Clarke DJ. Microbial metabolites as modulators of host physiology. Adv Microb Physiol 2024; 84:83-133. [PMID: 38821635 DOI: 10.1016/bs.ampbs.2023.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
The gut microbiota is increasingly recognised as a key player in influencing human health and changes in the gut microbiota have been strongly linked with many non-communicable conditions in humans such as type 2 diabetes, obesity and cardiovascular disease. However, characterising the molecular mechanisms that underpin these associations remains an important challenge for researchers. The gut microbiota is a complex microbial community that acts as a metabolic interface to transform ingested food (and other xenobiotics) into metabolites that are detected in the host faeces, urine and blood. Many of these metabolites are only produced by microbes and there is accumulating evidence to suggest that these microbe-specific metabolites do act as effectors to influence human physiology. For example, the gut microbiota can digest dietary complex polysaccharides (such as fibre) into short-chain fatty acids (SCFA) such as acetate, propionate and butyrate that have a pervasive role in host physiology from nutrition to immune function. In this review we will outline our current understanding of the role of some key microbial metabolites, such as SCFA, indole and bile acids, in human health. Whilst many studies linking microbial metabolites with human health are correlative we will try to highlight examples where genetic evidence is available to support a specific role for a microbial metabolite in host health and well-being.
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Affiliation(s)
- Susan A Joyce
- School of Biochemistry and Cell Biology, University College Cork, Cork, Ireland; APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - David J Clarke
- APC Microbiome Ireland, University College Cork, Cork, Ireland; School of Microbiology, University College Cork, Cork, Ireland.
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5
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Batinovic S, Chan HT, Stiles J, Petrovski S. Complete genome sequences of Providencia bacteriophages PibeRecoleta, Stilesk and PatoteraRojo. BMC Genom Data 2023; 24:49. [PMID: 37658299 PMCID: PMC10472563 DOI: 10.1186/s12863-023-01153-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/21/2023] [Indexed: 09/03/2023] Open
Abstract
OBJECTIVES Providencia is a genus of gram-negative bacteria within the order Enterobacterales, closely related to Proteus and Morganella. While ubiquitous in the environment, some species of Providencia, such as P. rettgeri and P. stuartii, are considered emerging nosocomial pathogens and have been implicated in urinary tract infection, gastrointestinal illness, and travelers' diarrhea. Given their intrinsic resistance to many commonly used antibiotics, this study aimed to isolate and sequence bacteriophages targeting a clinical P. rettgeri isolate. DATA DESCRIPTION Here we report the complete genome sequence of three novel Providencia phages, PibeRecoleta, Stilesk and PatoteraRojo, which were isolated against a clinical P. rettgeri strain sourced from a patient in a metropolitan hospital in Victoria, Australia. The three phages contain dsDNA genomes between 60.7 and 60.9 kb in size and are predicted to encode between 72 and 73 proteins. These three new phages, which share high genomic similarity to two other Providencia phages previously isolated on P. stuartii, serve as important resources in our understanding about Providencia bacteriophages and the potential for future phage-based biotherapies.
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Affiliation(s)
- Steven Batinovic
- Division of Materials Science and Chemical Engineering, Yokohama National University, Yokohama, Kanagawa, Japan.
| | - Hiu Tat Chan
- Department of Physiology, Anatomy, and Microbiology, La Trobe University, Bundoora, VIC, Australia
- Department of Microbiology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Jason Stiles
- Department of Microbiology, Royal Melbourne Hospital, Parkville, VIC, Australia
| | - Steve Petrovski
- Department of Physiology, Anatomy, and Microbiology, La Trobe University, Bundoora, VIC, Australia
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6
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Neniwal VK, Swain S, Rulaniya SK, Hota D, Agarwal P, Yadav PK. Purple urine bag syndrome: An unusual manifestation of urinary tract infection, our experience at a tertiary care center. Curr Urol 2023; 17:125-129. [PMID: 37691983 PMCID: PMC10489393 DOI: 10.1097/cu9.0000000000000044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 01/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background Purple urine bag syndrome (PUBS) is an unusual condition in which a purple discoloration of urine and bag occurs in people with urinary catheters. People with purple urine usually do not complain of any symptoms. The purple discoloration of the urine bag is often the only finding, frequently noted by caregivers. Materials and methods This prospective observational study was conducted at our tertiary care institute from June 2018 to May 2020. A total of 46 patients with PUBS were included in this study. The objective of our study was to record the prevalence of each predisposing factor and to correlate the pathological mechanism through which the PUBS is manifested. Results The mean age of PUBS patients was 67.4years and 67.4% were males. Most patients of PUBS (60.9%) had a urethral catheter, while there was percutaneous nephrostomy in 26.1% patients and 13% patients had a percutaneous suprapubic cystostomy catheter. Among the patients, 69.65% were bedridden or in an institutionalized situation, 73.9% were suffering from chronic constipation, 21.7% were associated with dementia, and 47.8% were cerebrovascular accidents with hemiparesis patients. In addition, 93.5% of patients presented with alkaline urine and 3 patients with acidic urine. The most common bacteria isolated in urine culture were E coli and Pseudomonas. Conclusions Urinary catheter associated urinary tract infection and PUBS is most commonly documented in females, but our study showed that it is more common in males. The appearance of a purple bag does not depend on the material and type of the catheter or the catheterization method. In addition, no correlation was found between the microorganisms isolated from the environment and patients' urine.
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Affiliation(s)
- Vishal Kumar Neniwal
- Department of Urology and Renal Transplant, SCB Medical College Cuttack, Odisha, India
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7
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Caggiano G, Amodio L, Stasi A, Colabufo NA, Colangiulo S, Pesce F, Gesualdo L. Gut-Derived Uremic Toxins in CKD: An Improved Approach for the Evaluation of Serum Indoxyl Sulfate in Clinical Practice. Int J Mol Sci 2023; 24:5142. [PMID: 36982216 PMCID: PMC10049313 DOI: 10.3390/ijms24065142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/26/2023] [Accepted: 03/01/2023] [Indexed: 03/10/2023] Open
Abstract
In the past years, indoxyl sulfate has been strongly implicated in kidney disease progression and contributed to cardiovascular morbidity. Moreover, as a result of its elevated albumin affinity rate, indoxyl sulfate is not adequately cleared by extracorporeal therapies. Within this scenario, although LC-MS/MS represents the conventional approach for IS quantification, it requires dedicated equipment and expert skills and does not allow real-time analysis. In this pilot study, we implemented a fast and simple technology designed to determine serum indoxyl sulfate levels that can be integrated into clinical practice. Indoxyl sulfate was detected at the time of enrollment by Tandem MS from 25 HD patients and 20 healthy volunteers. Next, we used a derivatization reaction to transform the serum indoxyl sulfate into Indigo blue. Thanks to the spectral shift to blue, its quantity was measured by the colorimetric assay at a wavelength of 420-450 nm. The spectrophotometric analysis was able to discriminate the levels of IS between healthy subjects and HD patients corresponding to the LC-MS/MS. In addition, we found a strong linear relationship between indoxyl sulfate levels and Indigo levels between the two methods (Tandem MS and spectrophotometry). This innovative method in the assessment of gut-derived indoxyl sulfate could represent a valid tool for clinicians to monitor CKD progression and dialysis efficacy.
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Affiliation(s)
- Gianvito Caggiano
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70122 Bari, Italy
| | - Loredana Amodio
- Biofordrug S.R.L., University of Bari Spin-Off, 70019 Triggiano, Italy
| | - Alessandra Stasi
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70122 Bari, Italy
| | - Nicola Antonio Colabufo
- Biofordrug S.R.L., University of Bari Spin-Off, 70019 Triggiano, Italy
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, 70122 Bari, Italy
| | | | - Francesco Pesce
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70122 Bari, Italy
| | - Loreto Gesualdo
- Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University of Bari “Aldo Moro”, 70122 Bari, Italy
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8
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Kannan L, Bauman AA. Purple urine in a patient with UTI and constipation. Oxf Med Case Reports 2023; 2023:omad013. [PMID: 36860965 PMCID: PMC9969816 DOI: 10.1093/omcr/omad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/05/2023] [Accepted: 01/23/2023] [Indexed: 03/03/2023] Open
Abstract
Purple urine bag syndrome (PUBS) is a visually striking and a rare side effect in a patient with urinary tract infection where urine in the catheter bags and tubing turn purple. The urine in PUBS gets its color from the combination of two pigments, indirubin and indigo, which are breakdown products of tryptophan. The most important risk factors include long-term catheterization, female gender, chronic constipation, old age and being bed bound. Here, we present a case of PUBS in an elderly female with a history of bladder cancer that needed catheterization along with constipation.
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Affiliation(s)
- Lakshmi Kannan
- Corresponding Author: Lakshmi Kannan, Department of Internal Medicine, Division of Nephrology, Adjunct Clinical Faculty, Pikeville Medical Center/University of Pikeville Kentucky College of Osteopathic Medicine, Pikeville, Kentucky- 41501. E-mail: , Tel: 804-325-7540
| | - Allison Ann Bauman
- Department of Nephrology, Pikeville Medical Center, Pikeville, KY, USA,University of Pikeville Kentucky College of Osteopathic Medicine, OMS IV, Pikeville, Kentucky, USA
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9
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Matsubara H, Maeda K, Kaname S. Purple urine bag syndrome. Clin Exp Nephrol 2022; 26:1240-1241. [PMID: 36056981 DOI: 10.1007/s10157-022-02266-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 08/14/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Hidehito Matsubara
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan.
| | - Keizo Maeda
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
| | - Shinya Kaname
- Department of Nephrology and Rheumatology, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo, 181-8611, Japan
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10
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Forde B, Yao L, Shaha R, Murphy S, Lunjani N, O'Mahony L. Immunomodulation by foods and microbes: Unravelling the molecular tango. Allergy 2022; 77:3513-3526. [PMID: 35892227 PMCID: PMC10087875 DOI: 10.1111/all.15455] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/15/2022] [Accepted: 07/23/2022] [Indexed: 01/28/2023]
Abstract
Metabolic health and immune function are intimately connected via diet and the microbiota. Nearly 90% of all immune cells in the body are associated with the gastrointestinal tract and these immune cells are continuously exposed to a wide range of microbes and microbial-derived compounds, with important systemic ramifications. Microbial dysbiosis has consistently been observed in patients with atopic dermatitis, food allergy and asthma and the molecular mechanisms linking changes in microbial populations with disease risk and disease endotypes are being intensively investigated. The discovery of novel bacterial metabolites that impact immune function is at the forefront of host-microbe research. Co-evolution of microbial communities within their hosts has resulted in intertwined metabolic pathways that affect physiological and pathological processes. However, recent dietary and lifestyle changes are thought to negatively influence interactions between microbes and their host. This review provides an overview of some of the critical metabolite-receptor interactions that have been recently described, which may underpin the immunomodulatory effects of the microbiota, and are of relevance for allergy, asthma and infectious diseases.
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Affiliation(s)
- Brian Forde
- APC Microbiome Ireland, UCC, Cork, Ireland.,School of Microbiology, UCC, Cork, Ireland
| | - Lu Yao
- APC Microbiome Ireland, UCC, Cork, Ireland.,School of Microbiology, UCC, Cork, Ireland
| | - Rupin Shaha
- APC Microbiome Ireland, UCC, Cork, Ireland.,School of Microbiology, UCC, Cork, Ireland
| | | | - Nonhlanhla Lunjani
- APC Microbiome Ireland, UCC, Cork, Ireland.,University of Cape Town, Cape Town, South Africa
| | - Liam O'Mahony
- APC Microbiome Ireland, UCC, Cork, Ireland.,School of Microbiology, UCC, Cork, Ireland.,Department of Medicine, UCC, Cork, Ireland
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11
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Nandwani A, Jha PK, Gadde A, Jain M. Purple Urine Bag Syndrome. Indian J Nephrol 2022; 32:646-647. [PMID: 36704590 PMCID: PMC9872912 DOI: 10.4103/ijn.ijn_226_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/03/2021] [Accepted: 12/03/2021] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ashish Nandwani
- Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta – The Medicity, Sector 38, Gurugram, Haryana, India
| | - Pranaw K. Jha
- Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta – The Medicity, Sector 38, Gurugram, Haryana, India
| | - Ashwini Gadde
- Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta – The Medicity, Sector 38, Gurugram, Haryana, India
| | - Manish Jain
- Department of Nephrology, Medanta Institute of Kidney and Urology, Medanta – The Medicity, Sector 38, Gurugram, Haryana, India
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Huff ML, Blome-Eberwein S. Providencia rettgeri Infection Compromising Post-Burn Recovery: A Lesson in the Importance of Follow-Up Care. Cureus 2022; 14:e25450. [PMID: 35774678 PMCID: PMC9239292 DOI: 10.7759/cureus.25450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/27/2022] [Indexed: 11/05/2022] Open
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Use of Raman Spectroscopy, Scanning Electron Microscopy and Energy Dispersive X-ray Spectroscopy in a Multi-Technique Approach for Physical Characterization of Purple Urine Bag Syndrome. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12084034] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purple urine bag syndrome (PUBS) is a rare condition characterized by purple discoloration of urine and urine bags. Although it is benign, it represents an alarming symptom to the patients and their relatives because of purple discoloration. We have physically characterized urine and urine bags belonging to a patient suffering from PUBS using an approach that combines Raman spectroscopy (RS) and scanning electron microscopy (SEM) coupled with energy dispersive X-ray (EDX). Five “blue” discolored bags and one sterile urine bag, representing the control, were cut into 1 cm2 square samples and analyzed by using RS and SEM + EDX technique. RS enabled us to identify the presence of indigo, a metabolite of tryptophan, while SEM analysis showed the biofilm deposit, probably due to the presence of microorganisms, and the EDX measurements exhibited the elemental composition of the bags. In particular, urine bags before and after the presence of PUBS urine showed an increase of ~32% of Cl, ~33% of O, ~667% of Ca, ~65% of Al and Mg, while C decreased by about 41%. Our results, to be taken as a proof-of-principle study, are promising for the aim to characterizing the urine bags in a flexible, inexpensive, and comprehensive manner.
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Analysis of purple urine bag syndrome by low vacuum scanning electron microscopy. Med Mol Morphol 2022; 55:123-130. [PMID: 35122146 PMCID: PMC9132813 DOI: 10.1007/s00795-022-00313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 01/19/2022] [Indexed: 11/18/2022]
Abstract
Purple urine bag syndrome (PUBS) is seen in the prolonged indwelling bladder catheters, and the mechanism of its onset was investigated using low vacuum scanning electron microscopy (LVSEM), which enables us to study the 3D structure of urinary sediments and urine bag walls. The urinary sediment and urine bags of 2 cases of PUBS were observed by LVSEM. The urine was brown turbid urine with a pH of 8.5, and magnesium phosphate stones and granules were observed in the urinary sediment together with Gram-positive and Gram-negative bacilli. Bacteria that moved by Brownian motion were observed with a dark-field microscope. LVSEM showed granular crystals around the bacilli, cocci, or mycelium that adhered to the walls of the bag. Granular crystals were dissolved in chloroform and presumed to be a mixture of the bacterial metabolites indigo blue and indirubin red. LVSEM also detected unusual tubular and honeycomb-like graphene in the urinary sediments, which were derived from the inner layer of the silicon elastomer-coated rubber catheter. LVSEM revealed purple crystals produced by bacteria or fungi attached to the urine bag that caused PUBS.
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15
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Mohib O, Roland T, Fontaine M, Laurent F, Rossi C. Purple urine bag syndrome is a rare manifestation of bacteriuria on bladder catheter: case report. AFRICAN JOURNAL OF UROLOGY 2021. [DOI: 10.1186/s12301-021-00191-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Purple urine bag syndrome (PUBS) is a complication of bacterial colonisation of bladder catheters in which urine turns purple in the tubing, as well as in the catheter bag. This rare phenomenon can be very worrisome and stressful for the patients and their families, as well as for the healthcare team taking care of them. Recognising this complication is essential in order to avoid misdiagnosis and erroneous treatment. We report a case of PUBS in a 71-year-old female patient.
Case presentation
A 71-year-old woman with previous medical history of schizophrenia was admitted to the emergency department for anorexia and suspicion of psychotic decompensation. Acute urine retention and rectal faecal impaction were clinically suspected and confirmed by bladder ultrasound and rectal examination, respectively. The patient underwent bladder catheterisation as well as a rectal enema. The day after her admission, our medical team was approached by the nurse in charge of the patient because of purple urine in her catheter bag and tubing. The diagnosis of PUBS was made with the help of the Oxford urine chart. A dipstick urinalysis revealed alkaline urine (pH = 8), and the urine culture was subsequently positive for Proteus mirabilis, which is sensitive to quinolones, beta-lactams and nitrofurantoin. The bladder catheter was changed. The patient received empiric antibiotic therapy with Levofloxacin 500 mg once daily. After obtaining the antibiogram, the targeted antibiotic therapy was adapted with oral Cefuroxime 500 mg three times a day for a total duration of seven days of antibiotic therapy. There was no recurrence of purple urine.
Conclusion
PUBS is a rare complication of bacteriuria, which induces a purple colouration of the tubing as well as the catheter bag. It is a simple spot diagnosis, as there is no other known cause of purple urine. This is why we believe that the Oxford urine chart represents a very interesting and easily accessible tool to help clinicians to investigate any abnormal urine colour.
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Thumser S, Köttner L, Hoffmann N, Mayer P, Dube H. All-Red-Light Photoswitching of Indirubin Controlled by Supramolecular Interactions. J Am Chem Soc 2021; 143:18251-18260. [PMID: 34665961 PMCID: PMC8867725 DOI: 10.1021/jacs.1c08206] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
![]()
Red-light responsiveness
of photoswitches is a highly desired property
for many important application areas such as biology or material sciences.
The main approach to elicit this property uses strategic substitution
of long-known photoswitch motives such as azobenzenes or diarylethenes.
Only very few photoswitches possess inherent red-light absorption
of their core chromophore structures. Here, we present a strategy
to convert the long-known purple indirubin dye into a prolific red-light-responsive
photoswitch. In a supramolecular approach, its photochromism can be
changed from a negative to a positive one, while at the same time,
significantly higher yields of the metastable E-isomer
are obtained upon irradiation. E- to Z-photoisomerization can then also be induced by red light of longer
wavelengths. Indirubin therefore represents a unique example of reversible
photoswitching using entirely red light for both switching directions.
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Affiliation(s)
- Stefan Thumser
- Friedrich-Alexander Universität Erlangen-Nürnberg, Department of Chemistry and Pharmacy, Nikolaus-Fiebiger-Str. 10, 91058 Erlangen, Germany
| | - Laura Köttner
- Friedrich-Alexander Universität Erlangen-Nürnberg, Department of Chemistry and Pharmacy, Nikolaus-Fiebiger-Str. 10, 91058 Erlangen, Germany
| | - Nadine Hoffmann
- Ludwig-Maximilians Universität München, Department of Chemistry and Center for Integrated Protein Science CIPSM, Butenandtstr. 5-13, 81377 Munich, Germany
| | - Peter Mayer
- Ludwig-Maximilians Universität München, Department of Chemistry and Center for Integrated Protein Science CIPSM, Butenandtstr. 5-13, 81377 Munich, Germany
| | - Henry Dube
- Friedrich-Alexander Universität Erlangen-Nürnberg, Department of Chemistry and Pharmacy, Nikolaus-Fiebiger-Str. 10, 91058 Erlangen, Germany
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Takahashi S, Arakawa S, Ishikawa K, Kamei J, Kobayashi K, Shigemura K, Takahashi S, Hiyama Y, Hamasuna R, Hayami H, Yazawa S, Yasuda M, Togo Y, Yamamoto S, Wada K, Watanabe T. Guidelines for Infection Control in the Urological Field, including Urinary Tract Management (revised second edition). Int J Urol 2021; 28:1198-1211. [PMID: 34480379 DOI: 10.1111/iju.14684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 08/17/2021] [Indexed: 01/08/2023]
Abstract
The Committee for the Development of Guidelines for Infection Control in the Urological Field, including Urinary Tract Management of the Japanese Urological Association, together with its systematic review team and external reviewers, have prepared a set of practice guidelines, an abridged version of which is published herein. These guidelines cover the following topics: (i) foundations of infection control, standard precautions, route-specific precautions, and occupational infection control (including vaccines); (ii) the relationship between urologists and infection control; (iii) infection control in urological wards and outpatient clinics; (iv) response to hepatitis B virus reactivation; (v) infection control in urological procedures and examinations; (vi) prevention of infections occurring in conjunction with medical procedures and examinations; (vii) responses to urinary tract tuberculosis and bacillus Calmette-Guérin; (viii) aseptic handling, cleaning, disinfection, and sterilization of urinary tract endoscopes (principles of endoscope manipulation, endoscope lumen cleaning, and disinfection); (ix) infection control in the operating room (principles of hand washing, preoperative rubbing methods, etc.); (x) prevention of needlestick and blood/bodily fluid exposure and response to accidental exposure; (xi) urinary catheter-associated urinary tract infection and purple urinary bag syndrome; and (xii) urinary catheter-associated urinary tract infections in conjunction with home care. In addressing these topics, the relevant medical literature was searched to the extent possible, and content was prepared for the purpose of providing useful information for clinical practice.
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Affiliation(s)
- Satoshi Takahashi
- Department of Infection Control and Laboratory Medicine, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Soichi Arakawa
- Department of Urology, Sanda City Hospital, Sanda, Hyogo, Japan
| | - Kiyohito Ishikawa
- Department of Quality and Safety in Healthcare, Division of Infection Control and Prevention, Fujita Health University Hospital, Toyoake, Aichi, Japan
| | - Jun Kamei
- Department of Urology, Jichi Medical University, Shimotsuke, Tochigi, Japan
| | - Kanao Kobayashi
- Department of Urology, Japan Organization of Occupational Health and Safety, Chugoku Rosai Hospital, Kure, Hiroshima, Japan
| | | | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Yoshiki Hiyama
- Department of Urology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
| | - Ryoichi Hamasuna
- Department of Urology, Federation of National Public Service and Affiliated Personal Mutual Aid Association, Shin-Kokura Hospital, Kitakyushu, Fukuoka, Japan
| | - Hiroshi Hayami
- Blood Purification Center, Kagoshima University Hospital, Kagoshima, Japan
| | - Satoshi Yazawa
- Yazawa Clinic, Tokyo, Japan.,Keio University School of Medicine, Tokyo, Japan
| | - Mitsuru Yasuda
- Center for Nutrition Support and Infection Control, Gifu University Hospital, Gifu, Japan
| | - Yoshikazu Togo
- Department of Urology, Kyowakai Medical Corporation Kyoritsu Hospital, Kawanishi, Hyogo, Japan
| | - Shingo Yamamoto
- Urology and Kidney Transplant Center, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Koichiro Wada
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
| | - Toyohiko Watanabe
- Department of Urology, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan
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18
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Saraireh M, Gharaibeh S, Araydah M, Al Sharie S, Haddad F, Alrababah A. Violet discoloration of urine: A case report and a literature review. Ann Med Surg (Lond) 2021; 68:102570. [PMID: 34354830 PMCID: PMC8321942 DOI: 10.1016/j.amsu.2021.102570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/09/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Purple Urine Bag Syndrome (PUBS) is an uncommon event that can be described as purple discoloration of urine due to a series of chemical reactions induced by Urinary Tract Infections (UTIs). PUBS has been reported in the past but still remains unrecognized by healthcare givers leading to misdiagnosis and inappropriate management. We report our case alongside a literature review of previously published cases. CASE PRESENTATION We present the first case report of Purple Urine Bag Syndrome in Jordan of a catheterized 80-year-old wheel-chaired female with a history of type 2 Diabetes Mellitus (DM), stage 5 Chronic Kidney Disease (CDK), Hypertension, and ischemic stroke. Her condition was initially misdiagnosed for hematuria but later on was correctly diagnosed with PUBS. She was treated with a course of appropriate antibiotic and by changing her urinary catheter and bag. The patient returned for a follow up visit and her problem resolved with the color of her urine in the urine bag returning back to normal. CLINICAL DISCUSSION PUBS is an uncommon event that occurs in association with UTIs. Such cases are mostly seen in elderly catheterized patients with other risk factors. CONCLUSION Purple Urine Bag Syndrome can be managed by changing urinary catheter, and by the administration of appropriate antibiotics. Such event can be easily misdiagnosed thus leading to unnecessary and consuming measures. Creating a better awareness of this condition among physicians and healthcare givers is essential for better patient outcomes.
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Affiliation(s)
| | | | | | | | - Fadi Haddad
- Faculty of Medicine, Yarmouk University, Irbid, Jordan
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19
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Karthikeyan C, Varaprasad K, Venugopal SK, Shakila S, Venkatraman B, Sadiku R. Biocidal (bacterial and cancer cells) activities of chitosan/CuO nanomaterial, synthesized via a green process. Carbohydr Polym 2021; 259:117762. [DOI: 10.1016/j.carbpol.2021.117762] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/26/2021] [Accepted: 01/28/2021] [Indexed: 12/23/2022]
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20
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Sriperumbuduri S, Brown PA, Clark EG. Purple Urine in a Patient with Refractory Hypotension. KIDNEY360 2021; 2:598-599. [PMID: 35369009 PMCID: PMC8786003 DOI: 10.34067/kid.0005362020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 09/14/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Sriram Sriperumbuduri
- Division of Nephrology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Canada
| | - Pierre-Antoine Brown
- Division of Nephrology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Canada,Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Edward G. Clark
- Division of Nephrology, Department of Medicine, The Ottawa Hospital and University of Ottawa, Ottawa, Canada,Kidney Research Centre, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
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21
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Verma S, Barwal KC, Singh D, Sharma V, Shrivastava M. Purple Urine Bag Syndrome: a Rare Benign Condition Associated with Chronic Indwelling Urinary Catheter and Bacterial Infection in an Elderly Man. Indian J Surg 2020. [DOI: 10.1007/s12262-019-01996-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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22
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Abe T, Onoda M, Matsuura T, Sugimura J, Obara W, Sasaki N, Kato T, Tatsumi K, Maruyama T. Evaluation of a new measurement method of indoxyl sulfate in hemodialysis patients. Ther Apher Dial 2020; 25:44-49. [PMID: 32281288 DOI: 10.1111/1744-9987.13500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/05/2020] [Accepted: 04/10/2020] [Indexed: 11/29/2022]
Abstract
Indoxyl sulfate (IS) is related to the development of cardiovascular disease and total mortality in dialysis patients. High-performance liquid chromatography (HPLC) is the conventional measurement approach. However, the HPLC method is difficult to perform in real time. Recently, the IS Assay Kit "NIPRO", which enables the measuring of total IS by the enzyme method, was developed. This new reagent allows the easy and quick measurement of many samples using the automatic biochemical analyzer. Moreover, it was reported that it demonstrated satisfactory analytical performance. If this enzyme method is useful for measuring IS in hemodialysis, we can expect that the mechanism in which the IS effects adversely on a body as uremic toxins will be clarified. However, the enzyme method is more easily influenced by other coexisting substances. In this study, we have assessed on how the uremic toxins and anticoagulation effect on this new reagent and evaluate whether it can be put into practice effectively for hemodialysis patients. For the enzyme method, accuracy, simultaneous repeatability, linearity, limit of detection, influence of coexisting materials, and correlation with the HPLC method were examined. Accuracy and simultaneous repeatability were satisfactory, and linearity was good. The limit of detection was acceptable, and there was no influence of coexisting materials. With regard to the correlation, the regression equation was y = 0.947X + 7.987 and the correlation coefficient (r) was 0.972. This new reagent showed sufficient fundamental performance and had a good correlation with the conventional HPLC method for assessing the plasma of dialysis patients.
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Affiliation(s)
- Takaya Abe
- Department of Urology, Iwate Medical University, School of Medicine, Morioka, Japan
| | - Mitsutaka Onoda
- Department of Urology, Iwate Medical University, School of Medicine, Morioka, Japan
| | - Tomohiko Matsuura
- Department of Urology, Iwate Medical University, School of Medicine, Morioka, Japan
| | - Jun Sugimura
- Department of Urology, Iwate Medical University, School of Medicine, Morioka, Japan
| | - Wataru Obara
- Department of Urology, Iwate Medical University, School of Medicine, Morioka, Japan
| | - Nariyuki Sasaki
- Dialysis Center, Seitetsu Memorial Hospital, Kamaishi, Japan
| | - Tetsuo Kato
- Dialysis Center, Seitetsu Memorial Hospital, Kamaishi, Japan
| | - Kenta Tatsumi
- Department III, Research & Development Laboratory, Medical Technology for Planning, Development & Marketing, Nipro Corporation, Kusatsushi, Japan
| | - Toru Maruyama
- Department of Biopharmaceutics, Kumamoto University, Graduate School of Pharmaceutical Sciences, School of Pharmacy, Kumamoto, Japan
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23
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Ong CY, Vasanwala FF. Gentleman with the Purple Urine. Korean J Fam Med 2020; 41:133-135. [PMID: 32208404 PMCID: PMC7093672 DOI: 10.4082/kjfm.18.0083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/12/2018] [Indexed: 11/03/2022] Open
Affiliation(s)
- Chong Yau Ong
- Department of Family Medicine, Sengkang Hospital, Singapore
- Department of General Psychiatry 2, Institute of Mental Health, Singapore
- *Corresponding Author: Chong Yau Ong https://orcid.org/0000-0002-6230-7134 Tel: +65-81268091, E-mail:
| | - Farhad Fakhrudin Vasanwala
- Department of Family Medicine, Sengkang Hospital, Singapore
- Department of General Psychiatry 2, Institute of Mental Health, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Singapore
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24
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Sabanis N, Paschou E, Papanikolaou P, Zagkotsis G. Purple Urine Bag Syndrome: More Than Eyes Can See. Curr Urol 2019; 13:125-132. [PMID: 31933590 PMCID: PMC6944938 DOI: 10.1159/000499281] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 09/26/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Purple urine bag syndrome (PUBS) is an uncommon clinical entity characterized by purple urine discoloration in the setting of urinary tract infections. Pa-thophysiology of PUBS has been correlated to aberrant metabolism of tryptophan. Multiple predisposing factors have been recognized, namely: female gender, advanced age, constipation, institutionalization, long-term catheter-ization, dementia and chronic kidney disease. Herein, we present a comprehensive review of all PUBS cases reported in PubMed, focusing on the predisposing factors and the microorganisms related to PUBS. METHODS We performed a search in PubMed database for articles referring to PUBS, published in English, French, Spanish and German from January 1978 until November 2017. The literature recruitment strategy was based on several keywords and Medical Subject Heading combination such as "purple urine bag syndrome" or PUBS or "urine discoloration". The finally selected articles were categorized into case reports/series (88 articles including 112 patients) and studies (10 articles including 134 patients). Demographical data as well as predisposing factors were recorded and further analyzed. RESULTS According to our findings, mean age of PUBS patients was 78.9 ± 12.3 years, 70.7% were female while 90.1% were suffering from constipation, 76.1% were in a bedridden situation, 45.1% were experiencing long-term catheterization, 42.8% had been diagnosed with dementia, 14.3% had recurrent urinary tract infections and 14.1% were chronic kidney disease patients. 91.3% of patients presenting with PUBS alkaline urine were observed while the most common microbe in urine cultures was E. coli. CONCLUSIONS PUBS is considered benign process in the majority of catheterized patients. Clinicians should be aware of the syndrome that may indicate serious comorbidities.
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Affiliation(s)
| | - Eleni Paschou
- Department of General Practice & Family Medicine, General Hospital of Livadeia, Voiotia, Greece
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25
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26
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Microstructural properties and antibacterial activity of Ce doped NiO through chemical method. SN APPLIED SCIENCES 2019. [DOI: 10.1007/s42452-019-0232-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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27
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Kumar D, Donga N, Macwan R. Purple Urine Bag Syndrome: A Scary but Easily Manageable Condition in a Patient with Prolonged indwelling Urinary Catheter. Indian J Palliat Care 2018; 24:534-536. [PMID: 30410271 PMCID: PMC6199850 DOI: 10.4103/ijpc.ijpc_88_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
“Purple urine bag syndrome” (PUBS) is a rare but distressing presentation of urinary tract infection (UTI) among moribund patients on indwelling urinary catheter. A 56-year-old woman with carcinoma of the left breast and metastasis in vertebrae and liver was bed ridden. She was on Foley's catheter for 9 months, with the last catheter changed 3 weeks back. A 75-year-old woman presented with non-Hodgkin's lymphoma for 2 years and moderately differentiated squamous cell carcinoma of the right parotid region (8 months). She experienced fall and fracture of femur, bed ridden, and on Foley's catheter for 7 years. She had facial wound with maggots for 3 days. Both the women developed purple-colored urine with no other symptoms of UTI. No investigations were carried out and they were empirically treated with nitrofurantoin, catheter change reassurance, and increased fluid intake. Urine color was normal by a week. PUBS can be managed easily at home with simple antibiotics, adequate hydration, and family/patient counseling in palliative care settings.
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Affiliation(s)
- Dinesh Kumar
- Department of Community Medicine, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Namrata Donga
- Department of Palliative Care, Shree Krishna Hospital, Karamsad, Gujarat, India
| | - Rekha Macwan
- Department of Palliative Care, Shree Krishna Hospital, Karamsad, Gujarat, India
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28
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Atherton JG, Hains DS, Bissler J, Pendley BD, Lindner E. Generation, clearance, toxicity, and monitoring possibilities of unaccounted uremic toxins for improved dialysis prescriptions. Am J Physiol Renal Physiol 2018. [PMID: 29537310 DOI: 10.1152/ajprenal.00106.2017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Current dialysis-dosing calculations provide an incomplete assessment of blood purification. They exclude clearances of protein-bound uremic toxins (PB-UTs), such as polyamines, p-cresol sulfate, and indoxyl sulfate, relying solely on the clearance of urea as a surrogate for all molecules accumulating in patients with end-stage renal disease (ESRD). PB-UTs clear differently in dialysis but also during normal renal function. The kidney clears PB toxins via the process of secretion, whereas it clears urea through filtration. Herein, we review the clearance, accumulation, and toxicity of various UTs. We also suggest possible methods for their monitoring toward the ultimate goal of a more comprehensive dialysis prescription. A more inclusive dialysis prescription would retain the kidney-filtration surrogate, urea, and consider at least one PB toxin as a surrogate for UTs cleared through cellular secretion. A more comprehensive assessment of UTs that includes both secretion and filtration is expected to result in a better understanding of ESRD toxicity and consequently, to reduce ESRD mortality.
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Affiliation(s)
- James G Atherton
- Department of Biomedical Engineering, University of Memphis , Memphis, Tennessee.,Le Bonheur Children's Hospital , Memphis, Tennessee
| | | | - John Bissler
- Le Bonheur Children's Hospital , Memphis, Tennessee
| | - Bradford D Pendley
- Department of Biomedical Engineering, University of Memphis , Memphis, Tennessee
| | - Ernő Lindner
- Department of Biomedical Engineering, University of Memphis , Memphis, Tennessee
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29
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Shin KS, Kim MY, Kang HN. Purple Urine Bag Syndrome in Geriatric Hospital: A Report of 2 Cases. Ann Geriatr Med Res 2018; 22:151-153. [PMID: 32743265 PMCID: PMC7387583 DOI: 10.4235/agmr.2018.22.3.151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 08/29/2018] [Accepted: 08/30/2018] [Indexed: 11/01/2022] Open
Abstract
Purple urine bag syndrome (PUBS) is a rare clinical condition that occurs in older women with a long-term urinary catheterization. Other risk factors include alkaline urine, constipation, renal disease, and immobility. It presents as purple discoloration of the urine bag and tubing and is a mixture of pigment that becomes purple. Patient with PUBS usually do not complain of any symptoms. The clinical course is generally benign, and intensive treatment is not usually needed. But awareness of this syndrome is necessary for doctor and nurse in geriatric hospital so as to adequately treat urinary tract infection and explain the clinical process to a caregiver. We present 2 cases of PUBS in a geriatric hospital.
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Affiliation(s)
- Kyung Su Shin
- Department of General Surgery, Yeosunoble Geriatric Hospital, Yeosu, Korea
| | - Mi Young Kim
- Department of Nursing, Yeosunoble Geriatric Hospital, Yeosu, Korea
| | - Hyo Nam Kang
- Department of Nursing, Yeosunoble Geriatric Hospital, Yeosu, Korea
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30
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Yang HW, Su YJ. Purple Urine Bag Syndrome in the Elderly. INT J GERONTOL 2018. [DOI: 10.1016/j.ijge.2018.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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31
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Kamelamela N, Zalesne M, Morimoto J, Robbat A, Wolfe BE. Indigo- and indirubin-producing strains of Proteus and Psychrobacter are associated with purple rind defect in a surface-ripened cheese. Food Microbiol 2018; 76:543-552. [PMID: 30166186 DOI: 10.1016/j.fm.2018.07.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 06/17/2018] [Accepted: 07/19/2018] [Indexed: 01/28/2023]
Abstract
The rinds of surface-ripened cheeses have expected aesthetic properties, including distinct colors, that contribute to overall quality and consumer acceptance. Atypical rind pigments are frequently reported in small-scale cheese production, but the causes of these color defects are largely unknown. We provide a potential microbial explanation for a striking purple rind defect in a surface-ripened cheese. A cheese producer in the United States reported to us several batches of a raw-milk washed-rind cheese with a distinctly purple rind. We isolated a Proteus species from samples with purple rind defect, but not from samples with typical rind pigments, suggesting that this strain of Proteus could be causing the defect. When provided tryptophan, a precursor in the indigo and indirubin biosynthesis pathway, the isolated strain of Proteus secreted purple-red pigments. A Psychrobacter species isolated from both purple and normal rinds also secreted purple-red pigments. Using thin-layer chromatography and liquid chromatography-mass spectrometry, we confirmed that these bacteria produced indigo and indirubin from tryptophan just as closely related bacteria make these compounds in purple urine bag syndrome in medical settings. Experimental cheese communities with or without Proteus and Psychrobacter confirmed that these Proteobacteria cause purple pigmentation of cheese rinds. Reports of purple rinds in two other cheeses from Europe and the observation of pigment production by Proteus and Psychrobacter strains isolated from other cheese rinds suggest that purple rind defect has the potential to be widespread in surface-ripened cheeses.
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Affiliation(s)
- Noelani Kamelamela
- Department of Biology, Tufts University, 200 Boston Ave., Medford, MA, 02155, USA
| | - Michael Zalesne
- Department of Biology, Tufts University, 200 Boston Ave., Medford, MA, 02155, USA
| | - Joshua Morimoto
- Tufts University Sensory and Science Center, Tufts University, 200 Boston Ave., Medford, MA 02155, USA; Department of Chemistry, Tufts University, 62 Talbot Ave., Medford, MA, 02155, USA
| | - Albert Robbat
- Tufts University Sensory and Science Center, Tufts University, 200 Boston Ave., Medford, MA 02155, USA; Department of Chemistry, Tufts University, 62 Talbot Ave., Medford, MA, 02155, USA
| | - Benjamin E Wolfe
- Department of Biology, Tufts University, 200 Boston Ave., Medford, MA, 02155, USA; Tufts University Sensory and Science Center, Tufts University, 200 Boston Ave., Medford, MA 02155, USA.
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32
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Lamas B, Natividad JM, Sokol H. Aryl hydrocarbon receptor and intestinal immunity. Mucosal Immunol 2018; 11:1024-1038. [PMID: 29626198 DOI: 10.1038/s41385-018-0019-2] [Citation(s) in RCA: 318] [Impact Index Per Article: 53.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 02/24/2018] [Accepted: 02/26/2018] [Indexed: 02/04/2023]
Abstract
Aryl hydrocarbon receptor (AhR) is a member of the basic helix-loop-helix-(bHLH) superfamily of transcription factors, which are associated with cellular responses to environmental stimuli, such as xenobiotics and oxygen levels. Unlike other members of bHLH, AhR is the only bHLH transcription factor that is known to be ligand activated. Early AhR studies focused on understanding the role of AhR in mediating the toxicity and carcinogenesis properties of the prototypic ligand 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). In recent years, however, it has become apparent that, in addition to its toxicological involvement, AhR is highly receptive to a wide array of endogenous and exogenous ligands, and that its activation leads to a myriad of key host physiological functions. In this study, we review the current understanding of the functions of AhR in the mucosal immune system with a focus on its role in intestinal barrier function and intestinal immune cells, as well as in intestinal homeostasis.
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Affiliation(s)
- Bruno Lamas
- Laboratoire de biomolécules, LBM, Sorbonne Université, École normale supérieure, PSL Research University, CNRS, INSERM, AP-HP, Hôpital Saint-Antoine, Paris, F-75005, France.,Micalis Institute, Institut National de la Recherche Agronomique (INRA), AgroParisTech, Université Paris-Saclay, Jouy en Josas, 78350, France
| | - Jane M Natividad
- Micalis Institute, Institut National de la Recherche Agronomique (INRA), AgroParisTech, Université Paris-Saclay, Jouy en Josas, 78350, France
| | - Harry Sokol
- Laboratoire de biomolécules, LBM, Sorbonne Université, École normale supérieure, PSL Research University, CNRS, INSERM, AP-HP, Hôpital Saint-Antoine, Paris, F-75005, France. .,Micalis Institute, Institut National de la Recherche Agronomique (INRA), AgroParisTech, Université Paris-Saclay, Jouy en Josas, 78350, France.
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33
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Traynor BP, Pomeroy E, Niall D. Purple urine bag syndrome: a case report and review of the literature. Oxf Med Case Reports 2018; 2017:omx059. [PMID: 29744118 PMCID: PMC5934649 DOI: 10.1093/omcr/omx059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Revised: 07/04/2017] [Accepted: 07/22/2017] [Indexed: 11/13/2022] Open
Abstract
Purple urine bag syndrome (PUBS) is a rare and striking manifestation associated with urinary tract infection involving bright purple discoloration of the lining and tubing of a urinary catheter bag. We present the interesting case of a 90-year-old female patient who developed PUBS and include a review of the relevant literature to date. Uniquely, in this case, PUBS acts as an important clinical sign in supporting the diagnosis of urinary tract infection in a high-risk patient.
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Affiliation(s)
- Bryan P Traynor
- Department of Orthopaedic Surgery, Midland Regional Hospital at Tullamore, Tullamore, Co. Offaly, Ireland
| | - Eoghan Pomeroy
- Department of Orthopaedic Surgery, Midland Regional Hospital at Tullamore, Tullamore, Co. Offaly, Ireland
| | - Dorothy Niall
- Department of Orthopaedic Surgery, Midland Regional Hospital at Tullamore, Tullamore, Co. Offaly, Ireland
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34
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Yang HW, Su YJ. Trends in the epidemiology of purple urine bag syndrome: A systematic review. Biomed Rep 2018. [PMID: 29564123 DOI: 10.3892/br.2018.1046.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purple urine bag syndrome (PUBS) is rarely observed in clinical practice. The present study aimed to identify the epidemiological trends in PUBS in recent decades. A search of PubMed articles published between 1980 October and 2016 August was conducted, in which 106 articles (174 cases) described PUBS. Of these cases, 58 cases were excluded: 14 cases without mention of gender, 4 cases without description of age, 37 cases without mention of white blood cell (WBC) count, shock status, fever status or description of etiology, and 3 cases without information on mortality. The remaining 116 PUBS cases were collected and analyzed in the present study. The articles were divided into three groups by publication year: 1991 to 2000, 2001 to 2010 and 2011 to 2016. The χ2 test was used for statistical analysis, with P<0.05 (two-tailed) defined as the threshold for significance. Of the total enrolled cases, there were 47 men (40.5%) and 69 women (59.5%), with a mean age ± standard deviation of 75.6±12.8 years. Of these, 98 cases (84.5%) were elderly (≥65 years old). A total of 93.1% of cases had a urine pH >7 while 6.9% of cases had acidic urine (pH <7). Furthermore, although WBC count elevated progressively, the mortality rate of patients with PUBS decreased over subsequent decades. This necessitates the advancement of antibiotics and application of early goal-directed therapy. Additionally, the overall mortality rate of PUBS (1980-2016) was 6.8%, which decreased to 4.3% in the last 5 years (2011-2016). In conclusion, although PUBS has previously been considered a benign process in the majority of indwelling catheterized patients, emphasis is required on early examination and aggressive antibiotic administration.
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Affiliation(s)
- Hsiu-Wu Yang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
| | - Yu-Jang Su
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan.,Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan.,Department of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.,Mackay Junior College of Medicine, Nursing and Management, New Taipei City 25245, Taiwan
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35
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Yang HW, Su YJ. Trends in the epidemiology of purple urine bag syndrome: A systematic review. Biomed Rep 2018; 8:249-256. [PMID: 29564123 PMCID: PMC5854937 DOI: 10.3892/br.2018.1046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Accepted: 01/23/2018] [Indexed: 02/07/2023] Open
Abstract
Purple urine bag syndrome (PUBS) is rarely observed in clinical practice. The present study aimed to identify the epidemiological trends in PUBS in recent decades. A search of PubMed articles published between 1980 October and 2016 August was conducted, in which 106 articles (174 cases) described PUBS. Of these cases, 58 cases were excluded: 14 cases without mention of gender, 4 cases without description of age, 37 cases without mention of white blood cell (WBC) count, shock status, fever status or description of etiology, and 3 cases without information on mortality. The remaining 116 PUBS cases were collected and analyzed in the present study. The articles were divided into three groups by publication year: 1991 to 2000, 2001 to 2010 and 2011 to 2016. The χ2 test was used for statistical analysis, with P<0.05 (two-tailed) defined as the threshold for significance. Of the total enrolled cases, there were 47 men (40.5%) and 69 women (59.5%), with a mean age ± standard deviation of 75.6±12.8 years. Of these, 98 cases (84.5%) were elderly (≥65 years old). A total of 93.1% of cases had a urine pH >7 while 6.9% of cases had acidic urine (pH <7). Furthermore, although WBC count elevated progressively, the mortality rate of patients with PUBS decreased over subsequent decades. This necessitates the advancement of antibiotics and application of early goal-directed therapy. Additionally, the overall mortality rate of PUBS (1980-2016) was 6.8%, which decreased to 4.3% in the last 5 years (2011-2016). In conclusion, although PUBS has previously been considered a benign process in the majority of indwelling catheterized patients, emphasis is required on early examination and aggressive antibiotic administration.
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Affiliation(s)
- Hsiu-Wu Yang
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
| | - Yu-Jang Su
- Department of Emergency Medicine, Mackay Memorial Hospital, Taipei 10449, Taiwan
- Department of Medicine, Mackay Medical College, New Taipei City 252, Taiwan
- Department of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan
- Mackay Junior College of Medicine, Nursing and Management, New Taipei City 25245, Taiwan
- Correspondence to: Dr Yu-Jang Su, Department of Emergency Medicine, Mackay Memorial Hospital, 92 Section 2 Chung-Shan North Road, Taipei 10449, Taiwan, E-mail:
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Dharmshaktu GS, Pangtey T. Purple urine bag as indicator of multidrug-resistant vulvar abscess: Lessons for primary caregivers. J Family Med Prim Care 2018; 7:484-485. [PMID: 30090805 PMCID: PMC6060925 DOI: 10.4103/jfmpc.jfmpc_230_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
| | - Tanuja Pangtey
- Department of Pathology, Government Medical College, Haldwani, Uttarakhand, India
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Guei MC, Yao KH, Lagou DA, Coulibaly PNA, Sawadogo A, Moudachirou MIA, Tia WM, Konan SD, Diopoh S, Cherif I, Ackoundou-N'Guessan KC, Gnionsahe DA. [Purple urine-bag syndrome: A case report]. Nephrol Ther 2018; 14:172-174. [PMID: 29415863 DOI: 10.1016/j.nephro.2017.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 11/07/2017] [Accepted: 11/19/2017] [Indexed: 10/18/2022]
Abstract
Purple urine-bag syndrome is a rare condition that occurs in patients with indwelling urinary catheters carried over a long period and frequently associated with a urinary tract infection. It is characterized by the appearance of a violet coloration of the probe and/or the urine collection bag. We report the first case in West Africa that occurred in a 47-year-old woman in uremic encephalopathy and carrier of a urinary catheter, which presented a violet color of the tubing and urine-bag associated with a urinary tract infection. The outcome was favorable under antibiotic therapy. Many patients benefit from the installation of urinary catheters for various reasons and the occurrence of this syndrome should lead the medical team to systematically seek an underlying urinary tract infection to avoid if possible paraclinical assessments generally costly to our patients without medical coverage in our developing countries.
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Affiliation(s)
- Monlet Cy Guei
- Service de néphrologie, CHU de Yopougon, BP 632, Abidjan 21, Côte d'Ivoire.
| | - Kouamé Hubert Yao
- Service de néphrologie, CHU de Treichville, Km 1, boulevard de Marseille, BP V 206, Abidjan, Côte d'Ivoire
| | | | | | - Amidou Sawadogo
- Service de néphrologie, CHU de Yopougon, BP 632, Abidjan 21, Côte d'Ivoire
| | | | - Weu Melanie Tia
- Service de néphrologie, CHU de Yopougon, BP 632, Abidjan 21, Côte d'Ivoire
| | - Serge Didier Konan
- Service de néphrologie, CHU de Treichville, Km 1, boulevard de Marseille, BP V 206, Abidjan, Côte d'Ivoire
| | - Sery Diopoh
- Service de néphrologie, CHU de Treichville, Km 1, boulevard de Marseille, BP V 206, Abidjan, Côte d'Ivoire
| | - Ibrahim Cherif
- Service de néphrologie, CHU de Yopougon, BP 632, Abidjan 21, Côte d'Ivoire
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Abstract
Purple discolouration of urine is not commonly encountered in accident and emergency departments. We report a case of an elderly gentleman on long-term urinary catheter who presented with purple discolouration of urine. He was found to have urinary tract infection caused by the bacteria Proteus mirabilis. The urine became clear after urinary catheter change and antibiotic treatment. This is called the purple urine bag syndrome and emergency physicians should be aware of this uncommon condition and the associated potentially dangerous conditions in order to initiate appropriate management.
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Kayal A, Dhanuka S, Mukhopadhyay BC, Mandal TK, Bansal CL. Purple urine bag syndrome in benign prostatic hyperplasia patient. RENAL REPLACEMENT THERAPY 2017. [DOI: 10.1186/s41100-017-0134-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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40
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Llenas-García J, García-López M, Pérez-Bernabeu A, Cepeda J, Wikman-Jorgensen P. Purple urine bag syndrome: A systematic review with meta-analysis. Eur Geriatr Med 2017. [DOI: 10.1016/j.eurger.2017.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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41
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Lin J, Hlafka M, Vargas O, Bhattarai M. Recurrent purple urine bag syndrome presenting with full spectrum of disease severity: case report and review of literature. CEN Case Rep 2017; 5:144-147. [PMID: 28508966 DOI: 10.1007/s13730-016-0213-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2015] [Accepted: 01/07/2016] [Indexed: 11/24/2022] Open
Abstract
Purple urine bag syndrome (PUBS) is a unique phenomenon characterized by purple discoloration of the urinary catheter bag and tubing following urinary catheterization lasting for hours to days. The purple discoloration is a mixture of indirubin dissolved in plastic with indigo on its surface. PUBS is most commonly associated with urinary tract infection (UTI) caused by bacteria with indoxyl phosphatase/sulfatase activity. It occurs predominantly in chronically catheterized, constipated elderly female patients. It usually appears to be asymptomatic and harmless, but rarely it can present as a severe illness. We report on a 29-year-old female with urinary ileal diversion presenting with multiple episodes of PUBS each with an asymptomatic state of varying severity, symptomatic UTI and severe sepsis requiring intensive care. To our knowledge, this is the first report where a single young patient had recurrent PUBS which presented with a full spectrum of disease severity at different occasions.
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Affiliation(s)
- Junzhi Lin
- Department of Internal Medicine, Southern Illinois University School of Medicine, 751 N Rutledge, PO BOX 19636, Springfield, IL, 62794-9636, USA.
| | - Martha Hlafka
- Department of Internal Medicine, Southern Illinois University School of Medicine, 751 N Rutledge, PO BOX 19636, Springfield, IL, 62794-9636, USA
| | - Omar Vargas
- Department of Internal Medicine, Southern Illinois University School of Medicine, 751 N Rutledge, PO BOX 19636, Springfield, IL, 62794-9636, USA
| | - Mukul Bhattarai
- Department of Internal Medicine, Southern Illinois University School of Medicine, 751 N Rutledge, PO BOX 19636, Springfield, IL, 62794-9636, USA
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42
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Richardson-May J. Single case of purple urine bag syndrome in an elderly woman with stroke. BMJ Case Rep 2016; 2016:bcr2016215465. [PMID: 27489067 PMCID: PMC4985987 DOI: 10.1136/bcr-2016-215465] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2016] [Indexed: 11/04/2022] Open
Abstract
Purple urine bag syndrome is an unusual condition that heralds an underlying urinary tract infection, in which certain bacteria produce a purple discolouration within the catheter bag of affected cases. It is most often seen in elderly women with constipation. While alarming, it can be resolved by treating the infection causing it. This report presents an elderly patient who developed the condition while an inpatient, and discusses the pathogenesis behind the condition.
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Hoekstra KA. The Case of the Purple Urinary Collection Bag. Clin Chem 2016; 62:1035-6. [DOI: 10.1373/clinchem.2015.249433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 10/26/2015] [Indexed: 11/06/2022]
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Faridi MS, Rahman MJ, Mibang N, Shantajit N, Somarendra K. Purple Urine Bag Syndrome- An Alarming Situation. J Clin Diagn Res 2016; 10:PD05-6. [PMID: 27042522 DOI: 10.7860/jcdr/2016/16622.7209] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 12/11/2015] [Indexed: 11/24/2022]
Abstract
Purple urine bag syndrome (PUBS) is an uncommon condition that occurs mainly in chronically catheterized patient and associated with urinary tract infection. It is characterised by purple discolouration of urine bag which leads to significant stress and anxiety to patient, care takers and health workers, so awareness regarding this condition is of utmost importance. In our report, an old gentleman with Benign Prostate Hyperplasia (BPH) on per urethral catheter (PUC) with past history of recurrent urinary tract infection developed burning micturition of urine with purple discoloration of urine bag. After proper antibiotic and catheter changed, discoloration subsided. In India, as life expectancy and geriatric care is improving, more patients are on PUC for various diseases. So, the incidence of PUBS will increase and awareness is required about the condition and its management.
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Affiliation(s)
- M S Faridi
- Resident, Department of Urology, Regional Institute of Medical Sciences , Imphal, Manipur, India
| | - Md Jawaid Rahman
- Resident, Department of Urology, Regional Institute of Medical Sciences , Imphal, Manipur, India
| | - Naloh Mibang
- Resident, Department of Urology, Regional Institute of Medical Sciences , Imphal, Manipur, India
| | - N Shantajit
- Resident, Department of Urology, Regional Institute of Medical Sciences , Imphal, Manipur, India
| | - Khumukchum Somarendra
- Registrar, Department of Urology, Regional Institute of Medical Sciences , Imphal, Manipur, India
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45
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Karim A, Abed F, Bachuwa G. A unilateral purple urine bag syndrome in a patient with bilateral nephrostomy tubes. BMJ Case Rep 2015; 2015:bcr-2015-212913. [PMID: 26701992 DOI: 10.1136/bcr-2015-212913] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A change in the colour of urine is always of clinical significance, and a source of concern for the patient and his physician. Among the different urine colours observed, purple is the least common. Although purple discolouration of a catheter and a urine bag is an uncommon finding, it was reported in the literature as early as 1978, by Barlow and Dickson. We present a unique case of purple urine bag syndrome in a patient with bilateral nephrostomy tubes (NT) and associated urine bags (UB) with only the left nephrostomy tube and urine bag exhibiting the purple colour, which resolved with a course of appropriate antibiotics eradicating the causative bacterial pathogen, and change of NT and UB.
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Affiliation(s)
- Adil Karim
- Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA
| | - Firas Abed
- Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA
| | - Ghassan Bachuwa
- Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA
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46
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Shah VD, Walton BJ, Culp AG, Castellino S. Investigation of Blue Bedding in Cages Housing Treatment-Naïve Hamsters. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2015; 54:799-802. [PMID: 26632791 PMCID: PMC4671797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/26/2015] [Accepted: 03/23/2015] [Indexed: 06/05/2023]
Abstract
During the acclimation phase of a preclinical safety study involving Syrian golden hamsters, some of the cages of treatment-naïve animals were noted to contain blue-tinged bedding; the urine of these hamsters was not discolored. We sought to understand the underlying cause of this unusual finding to ensure that the study animals were healthy and free from factors that might confound the interpretation of the study. Analysis of extracts from the blue bedding by using HPLC with inline UV detection and high-resolution mass spectrometry indicated that the color was due to the presence of indigo blue. Furthermore, the indigo blue likely was formed through a series of biochemical events initiated by the intestinal metabolism of tryptophan to an indoxyl metabolite. We offer 2 hypotheses regarding the fate of the indoxyl metabolite: indigo blue formation through oxidative coupling in the liver or through urinary bacterial metabolism.
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Affiliation(s)
- Vishal D Shah
- Drug Metabolism and Pharmacokinetics, GlaxoSmith-Kline, Research Triangle Park, North Carolina, USA
| | - Betsy J Walton
- Laboratory Animal Sciences, GlaxoSmith-Kline, Research Triangle Park, North Carolina, USA
| | - Amanda G Culp
- Drug Metabolism and Pharmacokinetics, GlaxoSmith-Kline, Research Triangle Park, North Carolina, USA
| | - Stephen Castellino
- Drug Metabolism and Pharmacokinetics, GlaxoSmith-Kline, Research Triangle Park, North Carolina, USA.
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47
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Neweling F, Janssens U. [Purple urine bag syndrome in a patient with bilateral nephrostomy]. Med Klin Intensivmed Notfmed 2015; 111:731-733. [PMID: 26472461 DOI: 10.1007/s00063-015-0103-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/31/2015] [Indexed: 10/22/2022]
Abstract
This article presents a case of purple urine bag syndrome (PUBS) with purple discoloration of urine in a patient with bilateral nephrostomy and acute renal failure. The discoloration of the urine is a product of bacterial metabolism. In principle, PUBS is benign and not of relevance for prognosis. However, it must be taken seriously as an indication for urinary tract infection and treated accordingly. Important for treatment is adequate urologic hygiene and care of urinary catheters for prevention of bacterial contamination as well as avoiding obstipation.
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Affiliation(s)
- F Neweling
- Klinik für Kardiologie, Elektrophysiologie und Rhythmologie, Krankenhaus Porz am Rhein, Urbacher Weg 19, 51149, Köln, Deutschland
| | - U Janssens
- Klinik für Innere Medizin und Internistische Intensivmedizin, St.-Antonius-Hospital Eschweiler, Dechant-Deckers-Str. 8, 52249, Eschweiler, Deutschland.
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48
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Purple Urine Bag Syndrome in Two Elderly Men with Urinary Tract Infection. Case Rep Nephrol 2015; 2015:746981. [PMID: 26351597 PMCID: PMC4553271 DOI: 10.1155/2015/746981] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 08/11/2015] [Indexed: 11/29/2022] Open
Abstract
Purple urine bag syndrome is a rare condition in which purple discoloration of urine inside its collection bag occurs. We describe two illustrative cases. The first patient is an 81-year-old man who was hospitalized for a newly diagnosed lymphoma with acute obstructive renal failure for which a nephrostomy procedure was performed. During the hospitalization, a sudden purple discoloration of the suprapubic catheter urine was noted, while the nephrostomy urine had a normal color. Urine culture from the suprapubic catheter was positive for Pseudomonas aeruginosa and Enterococcus faecalis; urine from the nephrostomy was sterile. The second case is an 80-year-old man who was admitted for heart failure with cardiorenal dilemma and who was started on intermittent hemodialysis. There was a sudden purple discoloration of the urine in the collection bag from his indwelling catheter. He was diagnosed with an E. coli urinary infection and treated with amoxicillin and removal of the indwelling catheter. These two cases illustrate the typical characteristics of purple urine bag syndrome.
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49
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Wie SH. Clinical significance of Providencia bacteremia or bacteriuria. Korean J Intern Med 2015; 30:167-9. [PMID: 25750557 PMCID: PMC4351322 DOI: 10.3904/kjim.2015.30.2.167] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Accepted: 02/01/2015] [Indexed: 11/27/2022] Open
Affiliation(s)
- Seong-Heon Wie
- Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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50
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Tür FÇ, Zafer N, Hocaoglu N. Purple urine bag syndrome. Emerg Med J 2014; 32:347. [PMID: 24876154 DOI: 10.1136/emermed-2014-203818] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 04/25/2014] [Indexed: 11/04/2022]
Affiliation(s)
- Feriyde Çalişkan Tür
- Department of Emergency Medicine, S.B. Izmir Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nur Zafer
- Department of Emergency Medicine, S.B. Izmir Tepecik Research and Training Hospital, İzmir, Turkey
| | - Nil Hocaoglu
- Department of Pharmacology, Dokuz Eylül University Medical School, Izmir, Turkey
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