Abstract
Purple urine bag syndrome (PUBS) is a condition in which the urinary catheter bag of some elderly patients develops an intense purple coloration. The purple discolouration of urine and bag is most often reported to be due to the indirubin dissolved in the plastic and indigo crystals in the urine, which coat the bag surface. Urinary indoxyl sulphate is derived from metabolised tryptophan in the gut. Urinary bacteria with indoxyl sulphatase activity metabolise indoxyl sulphate to produce indigo and indirubin, particularly in alkaline urine. Here, we report a 90-year-old woman with a Pseudomona aeruginosa, Klebsiella pneumonia, and Morganella moganii mixed urinary tract infection with constipation who presented with purple urine bag syndrome. The purple urine disappeared after antibiotic treatment and the following urinalysis was sterile. She was discharged in stable condition.
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