Purple urine bag syndrome

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Purple urine bag syndrome in a 90-year-old patient with urinary tract infection.

The purple urine bag syndrome (PUBS) is a rare phenomenon that can occur in patients with urinary catheters in combination with urinary tract infections , and which is characterized by a purple discoloration of the urine. This happens as a result of an enzymatic reaction of the bacteria causing the urinary tract infection .

Pathophysiology

Tryptophan ingested through food is converted to indole by bacteria in the digestive tract . This is transported through the bloodstream to the liver, where it is further converted to indoxyl sulfate . This is finally eliminated renally and excreted in the urine. The enzyme indoxylphosphatase is produced by bacteria that colonize the urinary catheter as a result of the infection . This enzyme converts the indoxyl sulfate in the urine into the red dye indirubin and the blue dye indigo , resulting in a purple color.

Several bacteria are able to do this, often Klebsiella pneumoniae , Proteus mirabilis , Escherichia coli , Pseudomonas aeruginosa , Morganella morganii , or Providencia spp. proven.

The phenomenon was first described in 1978. PUBS is more common in women, especially among nursing home residents. Other risk factors include long-term catheterization, immobility, constipation , kidney disease, urine with an alkaline pH value or use of urinary catheters made of polyvinyl chloride .

Symptoms and Treatment

The PUBS is a visual diagnosis. The purple discolored catheter and urinary bag are usually noticed when caring for the patient. In principle, the PUBS is harmless; for the patient, the phenomenon usually does not result in any additional symptoms other than the complaints that already exist due to the urinary tract infection. However, some studies suggest a connection with antibiotic-resistant germs.

As treatment, antibiotics are administered according to the antibiogram of the offending bacterium ( e.g. ciprofloxacin ) to treat the underlying infection, and the catheter should also be changed.

See also

Blue diaper syndrome

Individual evidence

  1. ^ CK Tan: Purple urine bag syndrome . In: Canadian Medical Association Journal . 179, No. 5, August 2008, p. 491. doi : 10.1503 / cmaj.071604 . PMID 18725621 . PMC 2518199 (free full text).
  2. ↑ CH Lin: Purple urine bag syndrome in nursing homes: ten elderly case reports and a literature review . In: Clinical Interventions in Aging . 3, No. 4, December 2008, pp. 729-734. PMID 19281065 . PMC 2682405 (free full text).
  3. ↑ a b FH Su: Case analysis of purple urine-bag syndrome at a long-term care service in a community hospital . In: Chang Gung Medical Journal . 28, No. 9, September 2005, pp. 636-642. PMID 16323555 .
  4. ^ GB Barlow: Purple urine bags . In: Lancet . 1, No. 8062, March 1978, p. 502. doi : 10.1016 / s0140-6736 (78) 90163-0 . PMID 76045 .
  5. ↑ DS Kalsi, J Ward, R Lee, A Handa: Purple urine bag syndrome: a rare spot diagnosis . In: Disease Markers . November 2017. doi : 10.1155 / 2017/9131872 . PMID 29317791 . PMC 5727662 (free full text).
  6. ↑ M Bhattarai: Purple urine bag syndrome may not be benign: a case report and brief review of the literature . In: Case Reports in Infectious Diseases . 2013, 2013. doi : 10.1155 / 2013/863853 . PMID 23864970 . PMC 3705812 (free full text).