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Purple Urine Bag Syndrome in an Elderly Female with Cerebrovascular Disease
Katrina Pattaguan
2024 ; 2024(1):
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춘계학술대회 초록집
Purple urine bag syndrome (PUBS) is a benign and rare phenomenon that is characterized by purple discoloration of the urine observed in catheter bags and tubings among admitted patients. It has a reported prevalence of 9.8% in hospitalized patients with long-term catheter use. PUBS is mostly a consequence of urinary tract infections producing indigo and indorubicin with red and blue colors respectively which when mixed produced the responsible purple discoloration. We present a case of a 93/F with history of chronic constipation on the background of limited mobility due to cerebrovascular infarct who developed fever and purple discoloration of her urine during admission. The discoloration led to referrals to different subspecialties including Nephrology service. Upon recognition of the case, patient was managed as a case of catheter related urinary tract infection with PUBS. Pertinent physical examination manifested diffuse tenderness upon palpation of the hypogastric area of the abdomen. Laboratories showed leukocytosis with neutrophilic predominance on blood count and urinalysis showed alkaline urine (pH of 8) with the urinary sediments of white blood cells 60-70/high power field. Collected specimen for urine cultures showed heavy growth of Escherichia coli (>100,000 cfu/mL). Culture guided antibiotic was started and completed and prompt catheter replacement was done. Immediate assurance to the patient and relatives were given. The purple discoloration abated after 3 days of antibiotics and complete resolution was seen after completion of antibiotics. Purple Urine Bag Syndrome, although a harmless occurrence, can be alarming to the patient and caregivers given the inexplicable sudden purple discoloration of the urine in the catheter bag. This being an under recognized phenomenon can lead to unwanted anxiety and morbidity if not timely managed. Familiarity with this syndrome will prompt immediate intervention leading to lesser hospital stay, avoidance of complications and unnecessary additional expenses.
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