Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report
Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the...
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MDPI AG
2023-08-01
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| Online Access: | https://www.mdpi.com/2227-9032/11/16/2251 |
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| author | Milka B. Popović Deana D. Medić Radmila S. Velicki Aleksandra I. Jovanović Galović |
| author_facet | Milka B. Popović Deana D. Medić Radmila S. Velicki Aleksandra I. Jovanović Galović |
| author_sort | Milka B. Popović |
| collection | DOAJ |
| description | Purple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for <i>Proteus mirabilis</i>. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment. |
| first_indexed | 2024-03-10T23:54:48Z |
| format | Article |
| id | doaj.art-e4566474664e4c4185c7fc47a410e811 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T23:54:48Z |
| publishDate | 2023-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-e4566474664e4c4185c7fc47a410e8112023-11-19T01:18:02ZengMDPI AGHealthcare2227-90322023-08-011116225110.3390/healthcare11162251Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case ReportMilka B. Popović0Deana D. Medić1Radmila S. Velicki2Aleksandra I. Jovanović Galović3Department of Hygiene, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, SerbiaDepartment of Microbiology, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, SerbiaDepartment of Hygiene, Faculty of Medicine, University of Novi Sad, Hajduk Veljkova 3, 21000 Novi Sad, SerbiaFaculty of Pharmacy Novi Sad, University of Business Academy, Trg Mladenaca 5, 21000 Novi Sad, SerbiaPurple urine bag syndrome (PUBS) is an uncommon, but usually benign, underrecognized clinical condition with the distressing presentation of purple, blue or reddish discoloration of a patient’s catheter bag and tubing in the setting of catheter-associated urinary tract infections (UTIs). PUBS is the result of the complex metabolic pathway of the dietary essential amino acid tryptophan. Its urinary metabolite, indoxyl sulfate, is converted into red and blue byproducts (indirubin and indigo) in the presence of the bacterial enzymes indoxyl sulfatase and phosphatase. The typical predisposing factors are numerous and include the following: female gender, advanced age, long-term catheterization and immobilization, constipation, institutionalization, dementia, increased dietary intake of tryptophan, chronic kidney disease, alkaline urine, and spinal cord injury (SCI). Here, we present a case of PUBS in a home-dwelling elderly female patient with a history of long-term immobility after a pathological spinal fracture, long-term catheterization, constipation, and malignant disease in remission. Urine culture was positive for <i>Proteus mirabilis</i>. This state can be alarming to both patients and physicians, even if the patient is asymptomatic. Healthcare professionals and caregivers need to be aware of this unusual syndrome as an indicator of bacteriuria in order to initiate proper diagnostics and treatment.https://www.mdpi.com/2227-9032/11/16/2251purple urine bag syndromepurple urine discolorationurinary tract infection<i>Proteus mirabilis</i>chronic indwelling urinary catheterspinal cord injury |
| spellingShingle | Milka B. Popović Deana D. Medić Radmila S. Velicki Aleksandra I. Jovanović Galović Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report Healthcare purple urine bag syndrome purple urine discoloration urinary tract infection <i>Proteus mirabilis</i> chronic indwelling urinary catheter spinal cord injury |
| title | Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report |
| title_full | Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report |
| title_fullStr | Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report |
| title_full_unstemmed | Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report |
| title_short | Purple Urine Bag Syndrome in a Home-Dwelling Elderly Female with Lumbar Compression Fracture: A Case Report |
| title_sort | purple urine bag syndrome in a home dwelling elderly female with lumbar compression fracture a case report |
| topic | purple urine bag syndrome purple urine discoloration urinary tract infection <i>Proteus mirabilis</i> chronic indwelling urinary catheter spinal cord injury |
| url | https://www.mdpi.com/2227-9032/11/16/2251 |
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