A Case of Purple Urine Bag Syndrome in a Spastic Partial Quadriplegic Male

Abstract

Purple bag urine syndrome (PUBS) is a benign and unique phenomenon of the urine turning a deep violet color within the urinary catheter tubing and bag. This phenomenon is commonly encountered in patients indicated with long-term catheter placement or, in certain conditions like chronic constipation, alkaline urine, limited ambulation, and, in terms of gender distribution, the female sex, predominates. PUBS gets its name from a unique phenomenon that takes places inside the gut where tryptophan (an amino acid) is metabolized, producing blue and red hues which together emanate a deep violet color. Here, the case of a middle-aged male patient with a suprapubic catheter in situ, following trauma causing spastic partial quadriplegia, is being presented with PUBS due to UTI secondary to Proteus vulgaris. The risk factors, in this case, include chronic constipation and recurrent urinary tract infections (UTIs).​

Trends in the epidemiology of purple urine bag syndrome: A systematic review

“…In the present study, 106 relevant articles were retrieved. Following application of the inclusion and exclusion criteria, 71 eligible articles ( 4 – 74 ) were selected (57 in English, 4 in French, 3 in Spanish, 3 in Japanese, 1 in Chinese, 1 in German, 1 in Icelandic and 1 in Czech; Fig. 1 and Table I ).…”

“…1 ). Therefore, 71 articles with patient data on 116 cases ( 4 – 74 ) were collected for review ( Table I ). The articles were divided into three groups by publication year: 1991 to 2000, 2001 to 2010 and 2011 to 2016.…”

Single case of purple urine bag syndrome in an elderly woman with stroke

“…The provocative organisms show increased growth in alkaline urine,9 although cases of PUBS in acidic urine have also been reported 10. Interestingly, despite PUBS being reported mostly in patients with long-term urinary catheters,11 our patient developed the condition only 1 week after insertion. This may be because of the extended period of constipation she had prior to catheter insertion, allowing for extensive metabolism of tryptophan and production of the compounds required for the development of the purple colour within the bag.…”

Purple urine bag syndrome in an 80-year-old female cameroonian

“…Even though alkaline urine has been reported by a majority of authors to be a risk factor for the development of PUBS, 1 2 6 7 8 it has also been described in patients with acidic urine. 9 10 …”

“… 5 6 The following bacteria have commonly been isolated in the urine of patients with PUBS; Pseudomonas aeruginosa, Proteus mirabilis, Providencia species, E. coli, Klebsiella pneumoniae, Morganella morganii, Citrobacter species, Methicillin-resistant Staphylococcus aureus , Group B streptococci, and Enterococcus species. 4 6 7 …”