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Volume 2017, Article ID 9131872, 6 pages
Review Article

Purple Urine Bag Syndrome: A Rare Spot Diagnosis

Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK

Correspondence should be addressed to Ashok Handa;

Received 28 June 2017; Accepted 18 September 2017; Published 29 November 2017

Academic Editor: Olav Lapaire

Copyright © 2017 Dilraj S. Kalsi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purple urine bag syndrome (PUBS) is a complication of urinary tract infections (UTIs) where catheter bags and tubing turn purple. It is alarming for patients, families, and clinicians; however, it is in itself a benign phenomenon. PUBS is the result of UTIs with specific bacteria that produce sulphatases and phosphatases which lead tryptophan metabolism to produce indigo (blue) and indirubin (red) pigments, a mixture of which becomes purple. Risk factors include female gender, immobility, constipation, chronic catheterisation, and renal disease. Management involves reassurance, antibiotics, and regular changing of catheters, although there are debates regarding how aggressively to treat and no official guidelines. Prognosis is good, but PUBS is associated with high morbidity and mortality due to the backgrounds of patients. Here, we review the literature available on PUBS, present a summary of case studies from the last five years, and propose the Oxford Urine Chart as a tool to aid such diagnoses.