Purple Urine Bag Syndrome in a Critically Ill Patient: Case Report

Abstract

Purple urine bag syndrome (PUBS) is a rare manifestation characterized by purple discoloration of the urine drainage system. It may appear as a disconcerting finding for patients and healthcare workers not aware of this condition. It’s mostly seen in patients with long-term urine catheterization and a coexisting urinary tract infection (UTI); however, this is not always the case. We describe the case of a 43-year-old patient with cervical cancer and end-stage renal disease who presented to the emergency room with fever and urinary retention which required catheterization. Three hours later, purple urine was noted in the bag. She was diagnosed with bacteremia and a urinary tract infection which were treated with intravenous antibiotics, eventually presenting an unfavorable clinical evolution. Although usually considered benign, it does not always run a harmless course. It’s important to assess this finding on a patient-specific basis to uncover a possible underlying UTI, considering that some may not be able to adequately communicate symptoms, as is the case of the critically ill or patients with communication difficulties. This report contributes to raising awareness and a better comprehension of this unusual entity.