Purple urine bag syndrome: report of an unusual case in a patient with a chronic urinary catheter.

Abstract

Purple urine bag syndrome (PUBS) is an infrequent and generally asymptomatic condition characterized by the purple coloration of urine in patients with a urinary catheter, secondary to bacterial metabolism of tryptophan and the production of pigments. We describe the case of an 82-year-old male with a history of benign prostatic hyperplasia, arterial hypertension, and chronic Foley catheter use, who presented for a preoperative consultation without symptoms, exhibiting purple urine of 48 hours' duration. The urine culture showed growth of extended-spectrum beta-lactamase-producing Klebsiella pneumoniae. Given the absence of urinary or systemic symptoms, it was decided not to administer antibiotics and to only replace the urinary drainage system. The patient progressed favorably, with resolution of the color change. PUBS, although striking, is a benign finding associated with asymptomatic bacteriuria, and its management should avoid unnecessary antibiotic use.