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Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report

Received: 3 November 2014     Accepted: 16 November 2014     Published: 20 November 2014
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Abstract

Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.

Published in Clinical Medicine Research (Volume 3, Issue 6)
DOI 10.11648/j.cmr.20140306.13
Page(s) 171-173
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Urinary Tract Infection

References
[1] Agapakis, D., et al., Purple Urine Bag Syndrome: a case report of an alarming phenomenon. Hippokratia, 2014. 18(1): p. 92-94.
[2] Dealler, S.F., et al., Purple urine bags. J Urol, 1989. 142(3): p. 769-70.
[3] Muneoka, K., et al., [Biochemical and bacteriological investigation of six cases of purple urine bag syndrome (PUBS) in a geriatric ward for dementia]. Nihon Ronen Igakkai Zasshi, 2008. 45(5): p. 511-9.
[4] Shiao, C.C., et al., Purple urine bag syndrome: a community-based study and literature review. Nephrology (Carlton), 2008. 13(7): p. 554-9.
[5] Su, F.H., et al., Case analysis of purple urine-bag syndrome at a long-term care service in a community hospital. Chang Gung Med J, 2005. 28(9): p. 636-42.
[6] Lin, H.-H., et al., Purple urine bag syndrome: a case report and review of the literature. J Intern Med Taiwan, 2002. 13: p. 209-12.
[7] Koh, K.S. and V.H. Chong, Purple urine bag syndrome (PUBS): an unusual and rare manifestation of a common condition. Ann Acad Med Singapore, 2013. 42(12): p. 700-1.
[8] Bhattarai, M., et al., Purple urine bag syndrome may not be benign: a case report and brief review of the literature. Case Rep Infect Dis, 2013. 2013: p. 863853.
[9] Al Montasir, A. and A. Al Mustaque, Purple urine bag syndrome. J Family Med Prim Care, 2013. 2(1): p. 104-5.
[10] Yaqub, S., S. Mohkum, and K.N. Mukhtar, Purple urine bag syndrome: A case report and review of literature. Indian J Nephrol, 2013. 23(2): p. 140-2.
[11] Fu-Hsiung Su, B., et al., Case analysis of purple urine-bag syndrome at a long-term care service in a community hospital. Chang Gung Med J, 2005. 28(9): p. 636-42.
Cite This Article
  • APA Style

    Reza Elahi, Seyed Morteza Tabatabaee, Seyed Alireza Heydariezade, Mitra Ranjbar. (2014). Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report. Clinical Medicine Research, 3(6), 171-173. https://doi.org/10.11648/j.cmr.20140306.13

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    ACS Style

    Reza Elahi; Seyed Morteza Tabatabaee; Seyed Alireza Heydariezade; Mitra Ranjbar. Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report. Clin. Med. Res. 2014, 3(6), 171-173. doi: 10.11648/j.cmr.20140306.13

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    AMA Style

    Reza Elahi, Seyed Morteza Tabatabaee, Seyed Alireza Heydariezade, Mitra Ranjbar. Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report. Clin Med Res. 2014;3(6):171-173. doi: 10.11648/j.cmr.20140306.13

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  • @article{10.11648/j.cmr.20140306.13,
      author = {Reza Elahi and Seyed Morteza Tabatabaee and Seyed Alireza Heydariezade and Mitra Ranjbar},
      title = {Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report},
      journal = {Clinical Medicine Research},
      volume = {3},
      number = {6},
      pages = {171-173},
      doi = {10.11648/j.cmr.20140306.13},
      url = {https://doi.org/10.11648/j.cmr.20140306.13},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20140306.13},
      abstract = {Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.},
     year = {2014}
    }
    

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    T1  - Purple Urine Bag Syndrome as a Rare Manifestation of Urinary Tract Infection: A Case Report
    AU  - Reza Elahi
    AU  - Seyed Morteza Tabatabaee
    AU  - Seyed Alireza Heydariezade
    AU  - Mitra Ranjbar
    Y1  - 2014/11/20
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    N1  - https://doi.org/10.11648/j.cmr.20140306.13
    DO  - 10.11648/j.cmr.20140306.13
    T2  - Clinical Medicine Research
    JF  - Clinical Medicine Research
    JO  - Clinical Medicine Research
    SP  - 171
    EP  - 173
    PB  - Science Publishing Group
    SN  - 2326-9057
    UR  - https://doi.org/10.11648/j.cmr.20140306.13
    AB  - Purple urine bag syndrome (PUBS) is purple discoloration of urinary catheter, tubing and bag and it is a rare and uncommon manifestation of urinary tract infection. Female gender, constipation, urinary tract infection, dementia, alkaline urine and high urinary bacterial counts are main risk factors. Here we report a 70 year old woman living in a nursing home presented with diarrhea, decreased oral intake and purple urine. The urine was evaluated and urine analysis showed PH=7 and pyuria. The result of urine culture was growth of more than 10¬0000 colony of Proteus Mirrabilis sensitive to Imipeneme. The patient condition improved after antibiotic therapy. The main reason of this phenomenon is not clearly recognized but some authors believe that Indigo (blue pigment) and Indirubin (red pigment) which are metabolite derivate of tryptophan can cause this uncommon discoloration. This condition is benign without any serious consequences and the treatment of underlying disease should be considered.
    VL  - 3
    IS  - 6
    ER  - 

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Author Information
  • Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran

  • Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran

  • Department of Internal Medicine, Iran University of Medical Sciences, Tehran, Iran

  • Department of Infectious Diseases, Iran University of Medical Sciences, Tehran, Iran

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