Acidic Urine Precipitating Purple Urine Bag Syndrome-A Puzzling Case Series
Keywords:
Purple urine;acidic purple urine;tryptophan metabolism.Abstract
Purple urine bag syndrome or purple bag syndrome is an unusual condition seen mostly in women who have been using a urinary catheter for prolonged periods of time.Commonly accompanied by alkalinised urine.On metabolization of tryptophan to produce indole, there is breakdown of indole into indoxyl sulphate.This is linked to bacterial urinary infections that produce sulphatase and phosphatase.Indoxyl sulphate on excretion is broken down into Indigo (blue) and indirubin (red), and their combination that results in purple, is to blame for the etiology.
An 80 year old male with Parkinsonism, a 77 year old female bedridden due to bilateral fracture neck of femur and an 84 year old male with discolored urine all presented with purple colored urine/urine bag.This case series is about the above 3 patients who presented with acidic urine and their management.
Purple urine bag syndrome or purple bag syndrome is a concerning condition for patients as well as their families however prompt investigations, oral or intravenous antibiotics and a change in catheter will help symptomatically.
