EAS Publisher | Purple Urine Bag Syndrome: A Fascinating Cause for Purple Discoloration of Urine

Purple Urine Bag Syndrome: A Fascinating Cause for Purple Discoloration of Urine

DOI : https://doi.org/10.36349/easjms.2021.v03i11.001

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Purple urine bag syndrome (PUBS) is a rare clinical condition in elderly constipated females on long term urinary catheters. By-products of dietary tryptophan metabolism are implicated in its pathogenesis. Bacteria in large intestine deaminate tryptophan to indole which is detoxificated in liver to indoxyl sulphate and excreted in urine. Uropathogens colonizing the catheter bags and tubes convert indoxyl sulphate to indigo (blue pigment) and indirubin (red pigment) under aerobic and anaerobic conditions respectively. The reaction between the above urinary pigments and polyvinyl chloride (PVC) is essential for the characteristic purple discoloration in urine. Asymptomatic patients are treated with regular catheter change and laxatives for constipation. Patients with symptomatic urinary tract infection, urosepsis, immunosuppression and persistent PUBS need antibiotics. Here we report PUBS in a patient with neurogenic bladder.

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