Purple urine bag syndrome in primary healthcare

a case report

Abstract

Introduction: Purple urine bag syndrome is an uncommon clinical presentation of urinary tract infection. It is characterized by the purple coloration of urine resulting from the metabolism of tryptophan to indole and subsequent conversion to indoxyl and formation of pigments by bacteria present in the urine. The bacterial agents commonly involved are: Escherichia coli, Enterococcus species, among others. The main associated risk factors are: Female sex, chronic catheterization and high urinary bacterial load. Case presentation: Woman, 65 years old, bedridden with multiple comorbidities, including chronic constipation, presented a purplish coloration in the collection bag of an indwelling urinary catheter (IUC). Urine tests showed the formation of colonies of Acinetobacter baumannii complex/haemolyticus. She was treated with Ciprofloxacin and the IVC was replaced to address the constipation and subsequently resolve the condition. Conclusions: Therefore, the approach to the syndrome includes resolving the infectious condition, changing indwelling catheters and modifying risk factors that may be involved in the condition.