An elderly man with purple urine

Boo, Woi Hon

doi:10.31128/ajgp-06-20-5499

Cited by 1 publication

(1 citation statement)

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“…In adults, a wide array of conditions may produce urinary discoloration: hematuria, myoglobinuria, porphyria, alkaptonuria, lipiduria, and the presence of certain microorganisms. In addition, numerous medications (amitriptyline, ibuprofen, propofol, L-dopa, phenytoin, flutamide, senna, and laxatives with a phenolphthalein component) as well as the consumption of intensively colored foods (beetroots, blackberries, fava beans, carrots, and rosehip tea) may produce changes in urine color, ranging from red or orange to blue-green [10,11]. After identification, an antibiotic sensitivity test was performed using the Kirby-Bauer disc diffusion method on Mueller-Hinton agar according to the recommendations of the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standard [7].…”

Section: Discussionmentioning

confidence: 99%

Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report

et al. 2023

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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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Section: Discussionmentioning

confidence: 99%