Purple urine bag syndrome: case report

Area of Science:

• Urology
• Infectious Diseases
• Medical Microbiology

Background:

• Chronic bladder catheterization is a common procedure in patients with various medical conditions.
• Urinary tract infections (UTIs) are a frequent complication of catheter use, particularly with indwelling catheters.
• Proteus mirabilis is a known uropathogen often associated with catheter-associated UTIs and encrustation.

Observation:

• A 65-year-old male patient with a history of urinary tract trauma and chronic bladder catheterization presented with unexplained purple discoloration of the urine collection bag.
• The patient had a confirmed urinary tract infection with Proteus mirabilis.
• Notably, the patient's urine itself did not exhibit a color change, with the discoloration localized to the urine bag system.

Findings:

• The observed symptoms are characteristic of Purple Urine Bag Syndrome (PUBS).
• PUBS is a benign, albeit visually striking, condition often associated with alkaline urine, bacterial metabolism, and indwelling urinary catheters.
• Proteus mirabilis, identified in this patient's urine culture, is frequently implicated in the pathogenesis of PUBS due to its urease production.

Implications:

• Despite its benign nature, PUBS is frequently underdiagnosed and underreported by healthcare professionals due to lack of awareness.
• Recognition of PUBS is crucial to avoid unnecessary patient anxiety and extensive diagnostic workups.
• Effective management involves addressing the underlying UTI and optimizing catheter care to prevent recurrence.