Purple Urine Bag Syndrome in Acidic Urine!

Abstract

Purple urine bag syndrome (PUBS) is a rare phenomenon, which usually occurs in chronically constipated women having long-term catheters. The underlying pathogenesis is linked to sulfatase producing bacteria in the urinary tract, which react to produce indigo (violet) and indirubin (red) pigment and the mixture gives a purple hue in the presence of alkaline urine. Treatment of the underlying urinary tract infection (UTI), change of catheter, and management of predisposing conditions prevent its recurrence. We report a case of a 74-year-old diabetic man who had Enterobacter cloacae-related UTI with PUBS in acidic urine and managed successfully.

Keywords

• enterobacter cloacae; indigo; indirubin; purple; sulfatase