[Purple urine bag syndrome]

The report of purple discoloration in a urinary drainage system, known as Purple Urine Bag Syndrome (P.U.B.S.) is rarely described in the literature.

In an 85 year-old woman, with permanent indwelling urinary catheter, the appearance of purple coloration in the urine collecting bag, without change in the colour of the urine, was observed four times in one year. During these different episodes, a Gram negative lower urinary infection diagnoses. The germs identified were Providencia stuartii and Citrobacter koseri. Symptoms resolved completely after treatment with ceftriaxone.

The clinical and biological symptoms usually described in cases of P.U.B.S. are observed in the medical history of this elderly woman: indwelling catheter with delay before onset of coloration greater than 15 days following catheterization, alkaline urinary pH, Gram negative lower urinary tract infection. However, during one of the episodes of PUBS in our patient, Citrobacter koseri was identified, germ not mentioned, as far as we know, in the literature. Moreover, in the published cases, Proteus species was identified as potentially associated with P.U.B.S., but a Proteus mirabilis urinary infection with was diagnosed in our patient, without any purple coloration of the urine in the collection bag.