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Purple Urine Bag Syndrome

  • John Casey and John Francescon
Published/Copyright: October 1, 2018
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 118 Issue 10

Keywords: catheterization; urinary tract infection; urology; urostomy

A patient presented to the emergency department with 2 weeks of dark urine, nausea, vomiting, and pain around her urostomy site. She was admitted for suspected bacterial sepsis, and subsequent urine cultures grew Providencia rettgeri, a species commonly associated with purple urine bag syndrome, which this patient had (image).1 The patient was discharged 3 days later after antibiotic administration and resolution of symptoms.

Purple urine bag syndrome is a phenomenon in which the urine bag and tubing in patients with long-term catheterization turn blue or purple secondary to a urinary tract infection. The pathogenesis of purple urine bag syndrome is related to the colonization of sulfatase- and phosphatase-producing bacteria that metabolize tryptophan into indigo and indirubin, which then accumulate and give urine the purple color.2

From US Acute Care Solutions, LLC, in Columbus, Ohio (Dr Casey), and Cleveland Clinic Akron General in Ohio (Dr Francescon).
Financial Disclosures: None reported.
Support: None reported.

*Address correspondence to: John Francescon, DO, Cleveland Clinic Akron General, 1 Akron General Ave, Akron, OH 44307-2432. Email:

References

1. Lin CH , HuangHT, ChienCC, TzengDS, LungFW. Purple urine bag syndrome in nursing homes: ten elderly case reports and a literature review. Clin Interv Aging. 2008;3(4):729-734.10.2147/CIA.S3534Search in Google Scholar

2. Hadano Y , ShimizuT, TakadaS, InoueT, SoranoS. An update on purple urine bag syndrome. Int J Gen Med. 2012;5:707-710. doi:10.2147/IJGM.S35320Search in Google Scholar PubMed PubMed Central

Accepted: 2017-12-28
Published Online: 2018-10-01
Published in Print: 2018-10-01

© 2018 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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https://doi.org/10.7556/jaoa.2018.151
Keywords for this article
catheterization; urinary tract infection; urology; urostomy
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. OMT MINUTE
  2. An Osteopathic Approach to Diagnosis and Management of Sacroiliac Joint Dysfunction
  3. SURF
  4. Analysis of Sexually Transmitted Diseases Within the Patient Population at a Student-Run Free Clinic
  5. OMT MINUTE
  6. An Osteopathic Approach to Rib Somatic Dysfunction in Respiratory Disorders
  7. ORIGINAL CONTRIBUTION
  8. Interrater Reliability of Osteopathic Sacral Palpatory Diagnostic Tests Among Osteopathy Students
  9. Validity of the Rule of Threes and Anatomical Relationships in the Thoracic Spine
  10. EVIDENCE-BASED CLINICAL REVIEW
  11. Concussion Evaluation and Management: An Osteopathic Perspective
  12. CLINICAL REVIEW
  13. Long-Term Oxygen Therapy in Patients With Chronic Obstructive Pulmonary Disease and Moderate Hypoxemia
  14. JAOA/AACOM MEDICAL EDUCATION
  15. Perceived Value of a Skills Laboratory With Virtual Reality Simulator Training in Arthroscopy: A Survey of Orthopedic Surgery Residents
  16. Using the Flipped Classroom With Simulation-Based Medical Education to Engage Millennial Osteopathic Medical Students
  17. SPECIAL COMMUNICATION
  18. Get With the PROGRAM: A Guide to Compassionate Communication
  19. CASE REPORT
  20. Osteopathic Evaluation of Urinary Retention Caused by Atypical Presentation of Invasive Cervical Cancer Mimicking Primary Urothelial Tumor
  21. CLINICAL IMAGES
  22. Purple Urine Bag Syndrome
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