Recurrent purple urine bag syndrome presenting with full spectrum of disease severity: case report and review of literature

Purple Urine Bag Syndrome: More Than Eyes Can See

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.

Purple urine bag syndrome: An unusual but important manifestation of urinary tract infection. Case report and literature review

Purple urine bag syndrome is a rare albeit alarming purple discolouration of the urine typically seen in elderly ladies with constipation, urinary tract infection and concurrent urinary catheterisation. In this concise review, we report the pathophysiology of this condition and the case of one patient who developed this interesting phenomenon.

Purple Urine Bag Syndrome in Geriatric Hospital: A Report of 2 Cases

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.

Purple Urine Bag Syndrome in an 80-year-old Female Cameroonian

Purple urine bag syndrome is a rare clinical entity commonly seen in elderly females with a long-term urinary catheterization. It presents as purple discoloration of the patient's plastic urine bag and tubing. We report the first case of this rare entity from Central Africa. We present the case of an 80-year-old female with purple urine associated with signs of urinary tract infection. Her symptoms resolved after 3 days of intravenous antibiotic treatment and diet modification. Purple urine bag syndrome remains rare, especially in African literature. Awareness of this benign syndrome is necessary for clinicians so as to adequately manage up to and including the associated anxiety.