Purple urinary bag syndrome: Our experience

Abstract

BackgroundPurple urinary bag syndrome (PUBS) is a visually striking and rare manifestation of urinary tract infection characterised by purple discolouration of the catheter and the urobag, which are seen primarily in patients who are on long-term indwelling catheter. This rare syndrome results due to the breakdown of indole, a by-product of dietary tryptophan metabolism, to coloured pigments indigo and indirubin by urinary bacteria, which reacts with the catheter and the bag to impart a purple colour. MethodsThis was a prospective observational study, wherein all cases of PUBS diagnosed between March 2012 and February 2020 were analysed and followed up. ResultsA total of five patients were presented with PUBS. Among them, four were women, and four were chronically constipated. All of them were elderly and debilitated with either being bed bound or having restricted mobility. Three of them had associated chronic kidney disease. All of them were treated successfully with change of catheters and antibiotics. ConclusionThis rare but alarming condition occurs in elderly patients who are on long-term indwelling catheters. The diagnosis is visually apparent, and the treatment may be just a simple change of catheter with oral antibiotics. The awareness may help in correct diagnosis and treatment.