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

Abstract

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.

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

“…PUBS was first reported in 1978 by Barlow and Dickson (quoted from 1,6) ). This syndrome is an uncommon condition characterized by purple urine in the urine bag and tubing in elderly women with prolonged urinary catheterization.…”

“…[6][7][8][9] Proposed risk factors are a long-term indwelling urinary catheter, female sex, older age, and the presence of chronic constipation, chronic renal disease, bedridden state, alkaline urine, and urinary tract infection. 1,5,10,11) The pathogenesis of PUBS is summarized in Fig. 2.…”

“…These pigments mix and react with the urine bag and tubing and produce a purple-colored urine. 1,5,[11][12][13] Several bacteria are often associated with PUBS. These bacteria are mainly gram negative and include Providencia rettgeri, Providencia stuartii, Proteus mirabilis, Klebsiella pneumonia, Enterococcus species, Escherichia coli, Morganella morganii, Pseudomonas aeruginosa, Citrobacter species, and group B streptococci.…”

“…It is assumed that intestinal bacteria are involved in the pathogenesis of PUBS. 1,5,10,11) Two studies 5,14) reported that patients with the syndrome had a benign clinical process. However, the occurrence of PUBS can be confusing to patients, their families, caregivers, and even inexperienced medical staff.…”

“…Purple urine bag syndrome (PUBS) is a rare syndrome associated with alkaline urine and sometimes urinary infections that are frequently observed in elderly women with long-term catheterization. 1,2) According to the national population statistics 3) published by the Ministry of the Interior and Safety of Korea at the end of 2017, 14.2% of the population was older than 65 years; thus, Korea is becoming a full-fledged senior society. The Korean Statistical Information Service 4) also reported 1,535 geriatric hospitals nationwide in the first quarter of 2018.…”