Review Article

Purple Urine Bag Syndrome: A Rare Spot Diagnosis

Table 1

A summary of case reports of PUBS in the last 5 years.

CaseKey details

Su et al. [3]81-year-old woman; PC = fever, discoloured urine; RFs = bedridden, chronic catheterisation; Ix = urine with Proteus mirabilis; Rx = IV antibiotics, catheter changed
Al Montasir and Al Mustaque [5]86-year-old female; PC = abdominal pain; PMH = osteoporosis, fractured hip, neurogenic bladder; RFs = bedridden, chronic catheterisation, constipation; Ix = alkaline urine with Escherichia coli; Rx = cefuroxime then ceftriaxone/gentamicin, glycerol preparation, catheter changed
Agapakis et al. [8]83-year-old female; PC = haematuria, fever; PMH = hypothyroidism, Alzheimer’s, colon cancer; RFs = bedridden, chronic catheterisation; Ix = misdiagnosed as haematuria, alkaline urine with E. coli; Rx = antibiotics, catheter changed
Duff [11]57-year-old female; PC = diffuse abdominal pain; PMH = transverse myelitis, recurrent UTIs, 2 C-sections; RFs = chronic catheterisation, colostomy bag; Ix = alkaline urine with Klebsiella pneumoniae; Rx = ciprofloxacin, catheter changed
Bhattarai et al. [10]87-year-old female; PC = altered mental status; PMH = dementia, hypertension, hyperlipidaemia, recurrent UTIs, left nephrostomy tube, right ureteral stent, end-stage renal disease; RFs = bedridden, kidney disease, constipated; Ix alkaline urine with Enterococci/Pseudomonas aeruginosa; Rx = vancomycin/cefepime
Mohamad and Chong [12]78-year-old female; PC = fever, vomiting; PMH = hyperlipidaemia, hypertension, dementia; RFs = bedridden, chronic catherisation; Ix = urine dip unremarkable, blood cultured Proteus mirabilis (sepsis); Rx ceftriaxone then ciprofloxacin
Yaqub et al. [13]83-year-old female; PC = nausea, vomiting, reduced oral intake, constipation, purple urine; PMH = dementia; RFs = bedridden, chronic catheterisation, recurrent UTIs; Ix = alkaline urine with Escherichia coli; Rx = cefixime, lactulose, catheter changed
Bocrie et al. [14]87-year-old female; PC = postfall syndrome, urinary retention, faecaloma; RFs = catheter; Ix = asymptomatic bacteriuria (Escherichia coli); Rx = catheter changed
Keenan and Thomas [15]97-year-old man; PC = purple urine, constipation; PMH = prostate hyperplasia, urinary retention; RFs = chronic catheterisation; Ix = urine with Klebsiella pneumoniae; Rx = ciprofloxacin
Siu and Watanabe [16]48-year-old man; PC = ischaemic encephalopathy after cardiac arrest; PMH = type 2 diabetes, coronary artery disease/bypass; RFs = recurrent UTIs, chronic catheterisation; Ix = alkaline urine with Escherichia coli; Rx = catheter changed, trimethoprim/sulfamethoxazole