scholarly journals A case of purple urine bag syndrome in an elderly patient

2020 ◽  
Vol 6 (3) ◽  
Author(s):  
Rosa Paola Cerra ◽  
Alberto Castagna ◽  
Carlo Torchia ◽  
Raffaele Costa ◽  
Luigi Scalise ◽  
...  
Keyword(s):  
Elderly Patient ◽  
Antibiotic Treatment ◽  
Bacterial Load ◽  
High Protein Diet ◽  
Rare Condition ◽  
The Elderly ◽  
Prevention Measures ◽  
Purple Urine Bag Syndrome ◽  
High Bacterial Load ◽  
Purple Urine

Purple urine bag syndrome is a rare condition that occurs predominantly in the elderly, immobilized and bearer of chronic bladder catheter. It is a phenomenon usually associated with urinary tract infection, particularly in the presence of high bacterial load. The presence of alkaline urine, constipation, high-protein diet and dehydration are predisposing factors. In most cases it is an asymptomatic condition. We described the case of an elderly patient admitted to the geriatric Department in which purple urine was found in the urine collection bag. The culture of urine showed the presence of infection with Klebsiella pneumoniae. Targeted antibiotic treatment and proper hydration determined the resolution of the phenomenon and the resolution of the infection. Although it is an alarming phenomenon due to the particularity of the color of the urine, it is a treatable and solvable condition with an adequate specific antibiotic treatment. Prevention measures are equally effective and consist in eliminating the risk factors for this condition.

scholarly journals Purple urine bag syndrome in an elderly patient from Colombia

2015 ◽  
Vol 9 (07) ◽  
pp. 792-795
Author(s):  
Alvaro Mondragón-Cardona ◽  
Carlos Eduardo Jiménez-Canizales ◽  
Verónica Alzate-Carvajal ◽  
Fabricio Bastidas-Rivera ◽  
Juan Carlos Sepúlveda-Arias
Keyword(s):  
Elderly Patient ◽  
Urinary Tract Infection ◽  
Nursing Home ◽  
Urinary Tract ◽  
Urinary Catheter ◽  
Intestinal Bacteria ◽  
Rare Condition ◽  
Alkaline Ph ◽  
Purple Urine Bag Syndrome ◽  
Purple Urine

A 71-year-old woman in a nursing home, with indwelling urinary catheter, bedridden, presented with a purple urine collector bag. The purple urine bag syndrome is a rare condition associated with the metabolism of tryptophan by overgrowth of intestinal bacteria. The purple color is formed by a combination of indigo and indirubin produced as a result of phosphatase and sulfatase enzymatic activity of bacteria on indoxyl sulfate, under alkaline pH of the urine. We present the second case of this syndrome reported in Colombia detailing the management of this rare syndrome associated with urinary tract infection. Several conditions should be considered in the differential diagnose of diseases that cause discoloration of the urine.

Purple urine bag syndrome: When the urine turns purple – An under diagnosed spot diagnosis

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Cathrin Kodde ◽  
◽  
Till Othmer ◽  
David Krieger ◽  
Silke Polsfuss ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Antibiotic Therapy ◽  
Urinary Catheter ◽  
Rare Condition ◽  
Community Acquired Pneumonia ◽  
Purple Urine Bag Syndrome ◽  
Indigo Blue ◽  
Tract Infections ◽  
Purple Urine

The Purple Urine Bag Syndrome (PUBS) is a rare condition in which the urine turns purple. It may occur in Urinary Tract Infections (UTIs) when bacteria metabolize dietary tryptophan to indole resulting in indigo (blue) and indirubin (red). This condition is mostly seen in elderly female patients with permanent urinary bladder catheterization. Patients, relatives and health professionals may be concerned about this discolouration, which is usually harmless. Medical management of PUBS involves frequent urinary bag change, antibiotic therapy and most importantly reassurance. We report an 89-years-old long-term catheterized female nursing home resident who was admitted to the emergency room because of a Community Acquired Pneumonia (CAP). After a few days of inpatient treatment her urine bag turned purple. Antibiotic therapy continued and the indwelling urinary catheter was changed resulting in clear urine. Keywords: Purple urine bag syndrome (PUBS); purple discolouration; urinary tract infection (UTI); long-term catheterization.

scholarly journals Case Report: Purple urine bag syndrome in woman with neurogenic bladder

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 979
Author(s):  
Senohadi Boentoro ◽  
Nugroho Budi Utomo
Keyword(s):  
Case Report ◽  
Chronic Constipation ◽  
Elderly Women ◽  
Urinary Catheter ◽  
The Elderly ◽  
Indwelling Catheter ◽  
Army Hospital ◽  
First Case ◽  
Purple Urine Bag Syndrome ◽  
Purple Urine

Purple urine bag syndrome (PUBS) is a rare phenomenon in patients that is associated with the use of a long-term/indwelling urinary catheter. The purple color results from indigo and indirubin, accumulated from bacteria-mediated tryptophan conversion. High risk patients include: the elderly; women; immobilized patients; patients with an indwelling catheter, chronic constipation, alkaline urine or poor hygiene; and those with catheter bags and tubes made of certain types of plastic. We reported PUBS in an elderly woman with an indwelling catheter and chronic constipation which, to our knowledge, was the first case in our hospital. The patient underwent urinary catheter change and received intravenous ciprofloxacin, following which the urine returned to a yellow color and the patient was discharged. This case report describes the diagnosis, management and also strategies for the prevention of PUBS in Gatot Soebroto Army Hospital, Indonesia.

scholarly journals Purple Urine Bag Syndrome May Not Be Benign: A Case Report and Brief Review of the Literature

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Mukul Bhattarai ◽  
Hamid Bin Mukhtar ◽  
Thomas Walter Davis ◽  
Alok Silodia ◽  
Hitekshya Nepal
Keyword(s):  
Rare Condition ◽  
Altered Mental Status ◽  
Nephrostomy Tube ◽  
Benign Condition ◽  
Tertiary Center ◽  
History Of ◽  
Purple Urine Bag Syndrome ◽  
Vancomycin Resistant ◽  
Purple Urine ◽  
Case Basis

Purple urine bag syndrome (PUBS) is a rare condition in which there is purple discoloration of the urine with its collecting bag and associated tubing occurs. It is considered a benign condition. We report an unusual case of PUBS in an 87-year-old female from nursing home who had a history of recurrent UTI. She also had a history of ureteral obstruction requiring left nephrostomy tube. She was brought to emergency department with altered mental status which developed five days after the occurrence of purple discoloration of the urinary bag. Her urine culture grew vancomycin-resistantEnterococci(VRE) andPseudomonas aeruginosa. She died within three days of hospitalization despite intensive care in tertiary center. This case highlights that PUBS may not always be benign and should be approached on a case-by-case basis because it may signal the underlying UTI which might be very difficult to treat. Failure of recognition of this peculiar color early could delay the appropriate intervention leading to fatal complication. This case also represents the rare occurrence of PUBS in the setting of nephrostomy tube.

scholarly journals A PUBS Case in a Palliative Care Unit Experience

2014 ◽  
Vol 2014 ◽  
pp. 1-2
Author(s):  
M. R. Restuccia ◽  
M. Blasi
Keyword(s):  
Palliative Care ◽  
Urinary Tract Infection ◽  
Rare Case ◽  
Rare Condition ◽  
Urinary Catheterization ◽  
Benign Condition ◽  
Alkaline Urine ◽  
Purple Urine Bag Syndrome ◽  
Purple Urine ◽  
Acidic Urine

Purple urine bag syndrome (PUBS) is a rare condition in which purple discoloration of the collecting bag and its associated tubing occurs. It is considered a benign condition. PUBS is usually associated with urinary tract infection occurring in elderly bedridden women, with chronic urinary catheterization. This syndrome is usually reported to occur in alkaline urine, but here we describe a rare case of PUBS involving acidic urine.

scholarly journals Purple Urine Bag Syndrome: Uncommon Clinical Entity Associated with Common Infection, Case Report

2020 ◽  
Vol 35 (3) ◽  
pp. 205-211
Author(s):  
Muftah H. Elkhafifi
Keyword(s):  
Urinary Tract ◽  
Elderly Women ◽  
Bacterial Load ◽  
Female Gender ◽  
Purple Urine Bag Syndrome ◽  
Polyvinyl Chloride Plastic ◽  
Indigo Blue ◽  
Tract Infections ◽  
Purple Urine ◽  
Common Infection

 Purple urine bag syndrome (PUBS) is a rare medical syndrome where purple discoloration of urine occurs predominantly in chronically constipated bedridden elderly women, chronically catheterized and associated with   urinary tract infections (UTIs). The etiology is related to UTIs with specific bacteria that produce sulphatase and phosphatase enzymes which lead tryptophan metabolism to produce two pigments: Indigo (blue) and indirubin (red), mixtures of which become purple in color. Several risk factors are associated with PUBS; including female gender, increased dietary tryptophan, alkaline urine, constipation, catheterization, high urinary bacterial load, renal failure and use of polyvinyl chloride plastic catheters. Herein, I present this rare benign interesting condition on a 78 years old lady with purple discoloration of her urine bag due to urinary tract infection caused by Escherichia coli that was successfully treated by culture guided antibiotic (Ciprofloxacin). The purple urine disappeared after antibiotic therapy and change of the urine catheter and bag.

scholarly journals Purple Urine Bag Syndrome in Two Elderly Men with Urinary Tract Infection

2015 ◽  
Vol 2015 ◽  
pp. 1-3
Author(s):  
Jan Van Keer ◽  
Daan Detroyer ◽  
Bert Bammens
Keyword(s):  
Rare Condition ◽  
Intermittent Hemodialysis ◽  
Suprapubic Catheter ◽  
Elderly Men ◽  
Indwelling Catheter ◽  
E Coli ◽  
Purple Urine Bag Syndrome ◽  
Catheter Urine ◽  
Purple Urine ◽  
Obstructive Renal Failure

Purple urine bag syndrome is a rare condition in which purple discoloration of urine inside its collection bag occurs. We describe two illustrative cases. The first patient is an 81-year-old man who was hospitalized for a newly diagnosed lymphoma with acute obstructive renal failure for which a nephrostomy procedure was performed. During the hospitalization, a sudden purple discoloration of the suprapubic catheter urine was noted, while the nephrostomy urine had a normal color. Urine culture from the suprapubic catheter was positive forPseudomonas aeruginosaandEnterococcus faecalis; urine from the nephrostomy was sterile. The second case is an 80-year-old man who was admitted for heart failure with cardiorenal dilemma and who was started on intermittent hemodialysis. There was a sudden purple discoloration of the urine in the collection bag from his indwelling catheter. He was diagnosed with anE. coliurinary infection and treated with amoxicillin and removal of the indwelling catheter. These two cases illustrate the typical characteristics of purple urine bag syndrome.

Purple urine bag syndrome in palliative care

2018 ◽  
Vol 9 (2) ◽  
pp. 155-157 ◽  
Author(s):  
Sanhapan Wattanapisit ◽  
Apichai Wattanapisit ◽  
Anong Meepuakmak ◽  
Pornnipa Rakkapan
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Rare Condition ◽  
Modifiable Risk Factors ◽  
Oral Antibiotics ◽  
Urinary Catheters ◽  
Patient Status ◽  
Palliative Care Teams ◽  
Purple Urine Bag Syndrome ◽  
Purple Urine

Purple urine bag syndrome (PUBS) is a rare condition characterised by urine discolouration. The management of PUBS remains controversial. Four females (mean age 84.5±9.7 years) with palliative conditions (two cancer and two non-cancer cases) presenting PUBS were identified. Urine bags were changed in all cases. Urinary catheters were changed in three cases. Oral antibiotics were prescribed in two cases and used in one case. Urine discolouration was resolved in all cases. One patient (without antibiotic treatment) died on day 5 after presentation of PUBS. Three patients (one out of three cases used oral antibiotics) were clinically stable after the management of PUBS. There was no recurrence of PUBS. Caring for patients with PUBS should be based on clinical decisions, patient status and the goals of care. Palliative care teams should focus on the prevention of PUBS by shortening the duration of catheterisation and minimising modifiable risk factors for this condition.

scholarly journals Measurement of the Intestinal pH in Mice under Various Conditions Reveals Alkalization Induced by Antibiotics

Antibiotics ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 180
Author(s):  
Kouki Shimizu ◽  
Issei Seiki ◽  
Yoshiyuki Goto ◽  
Takeshi Murata
Keyword(s):  
Antibiotic Treatment ◽  
High Protein Diet ◽  
Intestinal Bacteria ◽  
High Protein ◽  
Protein Diet ◽  
Germ Free ◽  
Treatment Regimens ◽  
Ph Values ◽  
Specific Pathogen ◽  
The Stability

The intestinal pH can greatly influence the stability and absorption of oral drugs. Therefore, knowledge of intestinal pH is necessary to understand the conditions for drug delivery. This has previously been measured in humans and rats. However, information on intestinal pH in mice is insufficient despite these animals being used often in preclinical testing. In this study, 72 female ICR mice housed in SPF (specific pathogen-free) conditions were separated into nine groups to determine the intestinal pH under conditions that might cause pH fluctuations, including high-protein diet, ageing, proton pump inhibitor (PPI) treatment, several antibiotic treatment regimens and germ-free mice. pH was measured in samples collected from the ileum, cecum and colon, and compared to control animals. An electrode, 3 mm in diameter, enabled accurate pH measurements with a small amount of gastrointestinal content. Consequently, the pH values in the cecum and colon were increased by high-protein diet, and the pH in the ileum was decreased by PPI. Drastic alkalization was induced by antibiotics, especially in the cecum and colon. The alkalized pH values in germ-free mice suggested that the reduction in the intestinal bacteria caused by antibiotics led to alkalization. Alkalization of the intestinal pH caused by antibiotic treatment was verified in mice. We need further investigations in clinical settings to check whether the same phenomena occur in patients.

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