Purple urine bag syndrome

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For other uses, see PUBS (disambiguation page)

Purple urine bag syndrome (PUBS) is a medical syndrome in which urine violet color changes occur in people with urinary catheters and urinary tract infections together. Bacteria in the urine produce indoxyl phosphatase enzymes. It converts the indoxyl sulfate in urine into a red and blue indirubin and indigo compound. The most commonly involved bacteria are Providencia stuartii Providencia rettgeri , Klebsiella pneumoniae , Proteus mirabilis , Escherichia coli, Morgan Morgan, and Pseudomonas aeruginosa.

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Signs and symptoms

People with purple bladder syndrome usually do not complain of any symptoms. The purple color change in the bladder is often the only finding, often noted by caregivers. Usually considered a benign condition, although in the setting of recurrent or chronic urinary tract infections, it may be associated with drug-resistant bacteria.

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Pathophysiology

Tryptophan in the diet is metabolized by bacteria in the digestive tract to produce indole. Indole is absorbed into the blood by the intestine and passes to the liver. There, indole is converted to indoxyl sulfate. Indoxyl sulfate is excreted in the urine. In purple bladder syndrome, bacteria that colonize the urinary catheter alter indoxyl sulfate to indirubin and indigo.

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Diagnosis

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Treatment

Antibiotics such as ciprofloxacin as given and catheters should be altered. If constipation is present, it should also be treated.

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Epidemiology

Purple bladder syndrome is more common in nursing home residents. Other risk factors include the use of alkaline urine, constipation, and polyvinyl chloride catheters.

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History

This syndrome was first described by Barlow and Dickson in 1978.

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References

Source of the article : Wikipedia