Abstract
The purple urine bag syndrome (PUBS ) is a rare phenomenon consisting of a urine discolouration in patients with long term urinary catheterization who develop urinary tract infection. The main risk factors are: elderly age, female sex, chronic constipation, alkaline urine with high bacterial levels and bedridden status. It occurs when the product of the amino acid tryptophan is metabolized to indoxyl sulfate. This substance due to bacterial enzyme reactions and in the alkaline environment gets oxygenized to indigo (blue) and indirubin (red), which precipitate in the urine and on to the synthetic material of the urinary catheter and urine bag, resulting in the characteristic purple color. We present a case of an 85-year-old woman who was deteriorating from advanced cancer (colon cancer with liver cirrhosis) who developed purple urine bag syndrome.
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