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Wang J, Tang X, Zhang X, Meng Z. A case of purple urinary bag syndrome treated with non-antibiotic methods combined with bladder function training. Asian J Surg 2024; 47:2393-2394. [PMID: 38262793 DOI: 10.1016/j.asjsur.2024.01.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024] Open
Affiliation(s)
- Junya Wang
- Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xiaojia Tang
- Department of Rehabilitation Medicine, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Xibin Zhang
- Department of Rehabilitation Medicine, Clinical Medical College, Yangzhou University, Yangzhou, China.
| | - Zhaoxiang Meng
- Department of Rehabilitation Medicine, Clinical Medical College, Yangzhou University, Yangzhou, China.
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Popović MB, Medić DD, Velicki RS, Jovanović Galović AI. Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report. Healthcare (Basel) 2023; 11:2251. [PMID: 37628449 PMCID: PMC10454558 DOI: 10.3390/healthcare11162251] [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: 06/29/2023] [Revised: 08/04/2023] [Accepted: 08/07/2023] [Indexed: 08/27/2023] Open
Abstract
Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient's catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for Proteus mirabilis. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment.
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Affiliation(s)
- Milka B. Popović
- Department of Hygiene, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Center for Hygiene and Human Ecology, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
| | - Deana D. Medić
- Department of Microbiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Center for Microbiology, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
| | - Radmila S. Velicki
- Department of Hygiene, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, Serbia;
- Center for Hygiene and Human Ecology, Institute of Public Health of Vojvodina, Futoška 121, 21000 Novi Sad, Serbia
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Vanumu DS, Mantha SP, Suvvari P, Kodisharapu PK. Prolonged Indwelling Percutaneous Nephrostomy Leading to Purple Urinary Bag Syndrome in Palliative Care Setting: A Case Report. Indian J Palliat Care 2023; 29:324-327. [PMID: 37700888 PMCID: PMC10493687 DOI: 10.25259/ijpc_162_2022] [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: 07/11/2022] [Accepted: 06/07/2023] [Indexed: 09/14/2023] Open
Abstract
Purple urine bag syndrome (PUBS) is a complication and a rare phenomenon associated with bacterial colonisation in bladder catheters in which urine turns purple in the tubing and the catheter bag. This condition can be distressing and panicking for the patients and their families as well as the medical staff caring for them. It is an interesting and unusual presentation that affects people with long-term indwelling catheters and chronic constipation. We report one such case in our hospital, a 73-year-old woman with stage 4 cancer of the vaginal vault, post-bilateral percutaneous nephrostomy (PCN) 4 months ago, currently on best supportive care, presented to the emergency room with symptoms of urosepsis, while a purple urine bag may appear innocuous and not need any particular care beyond replacing the catheter and giving the patient the proper antibiotics, it may indicate an occult urinary tract infection (UTI), which can have catastrophic effects in a patient using a urinary catheter for an extended period of time. Only a few examples of PUBS with an underlying nephrostomy have been documented in the literature. This is a case of a palliative care patient who had a poor prognosis despite receiving the right antibiotic treatment for an upper UTI that caused purple staining of the PCN catheter bag. Using this case report as a guide, we could manage a complex UTI in a palliative care context.
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Affiliation(s)
- Divya Sai Vanumu
- Department of Palliative Medicine, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - Shyam Prasad Mantha
- Department of Onco Anaesthesia, Palliative Medicine, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - Praneeth Suvvari
- Department of Palliative Medicine, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - Praveen Kumar Kodisharapu
- Department of Palliative Medicine, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
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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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Campagne J, Kurt S, Moulinet T, Mohamed S, Deibener-Kaminsky J, Jaussaud R. Une couleur inhabituelle. Rev Med Interne 2020; 42:61-62. [PMID: 32709435 PMCID: PMC7374124 DOI: 10.1016/j.revmed.2020.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 05/21/2020] [Indexed: 11/24/2022]
Affiliation(s)
- J Campagne
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - S Kurt
- Service d'Hépato-Gastro-Entérologie, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - T Moulinet
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France.
| | - S Mohamed
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - J Deibener-Kaminsky
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
| | - R Jaussaud
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalo-Universitaire de Nancy, Hôpitaux de Brabois, Rue du Morvan, 54511 Vandœuvre-Lès-, Nancy Cedex., France
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Chong VH. Misconception about purple urine bag syndrome. QJM 2020; 113:445. [PMID: 31909795 DOI: 10.1093/qjmed/hcz333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- V H Chong
- Department of Medicine, PMMPHAMB Hospital, Tutong, Brunei Darussalam
- Department of Medicine, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam
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