Purple Urine Bag Syndrome: An Unusual Presentation of Urinary Tract Infection

Abstract

Purple urine bag syndrome (PUBS) is a very rare phenomenon strongly associated with long-term indwelling catheterization that results in an increased risk of urinary tract infection. The color change in the urine bag results from the altered metabolism of tryptophan into color pigments by certain bacteria which produce sulfates and phosphates enzymes. Although it is benign in nature, PUBS results in greater anxiety among patients and their families. The most important risk factors include long-term catheterization, female gender, chronic constipation, old age and bed-bound patients. Here, we present a case of PUBS in a middle-aged woman with a history of the neurogenic bladder that needed long-term catheterization along with chronic constipation. Keywords: purple urine bag, purple urine bag syndrome, tryptophan, urinary catheters, indigo, indirubin