Abstract
Diagnosis: Purple urine bag syndrome. Purple urine bag syndrome (PUBS) is an uncommon phenomenon in which the urine bags of chronically catheterized individuals turn a purple or blue color [1-3]. The condition usually affects elderly women. Most patients are bedridden, and many have cognitive impairment. Constipation has been reported as a frequent symptom in these patients [4]. The purple discoloration of the catheter bags is due to the presence of the purple pigment indigo and the blue pigment indirubin [1, 5]. The proposed mechanism for pigment production is through altered metabolism of tryptophan [6]. Owing to altered gut motility or intestinal bacterial overgrowth, tryptophan is exposed to intestinal flora before it can be absorbed. The bacteria deaminate the tryptophan to yield indole,
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