Mohd Hasim, Muhammad Syazwan and Mansor, Noor Emilia Emira and Md. Aris, Mohd. Aznan (2026) Purple urine bag syndrome: a rare but striking presentation of UTI. In: 10th International Virtual Medical Research Symposium, 3-4 February 2026, Virtual.
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Abstract
Introduction: Purple Urine Bag Syndrome (PUBS) is an uncommon but striking phenomenon characterised by purple discolouration of the urine drainage bag, typically occurring in patients with long-term indwelling urinary catheters. It is frequently associated with catheter-associated urinary tract infection (CAUTI) caused by indoxyl-sulfatase–producing bacteria. Patients with neurogenic bladder and prolonged catheterisation are particularly vulnerable. Methods: We report a 62-year-old semi-dependent male with neurogenic bladder and multiple comorbidities, including heart failure with preserved ejection fraction, hypertension, and previous cerebrovascular accident. He had previously declined suprapubic catheterisation and continued on long-term urethral catheterisation. The use of a non-silicone Foley catheter and frequent delays in catheter changes further increased his risk of infection. He presented to primary care for a routine but overdue catheter change, during which the urine bag was noted to be purple. Clinical assessment, urinalysis, urine culture, and treatment response were documented. Results: The patient was afebrile and haemodynamically stable. Urinalysis showed leukocyte 1+, blood 1+, protein 2+, and a positive nitrite test. Catheter replacement resulted in clearer urine. Empirical oral amoxicillin-clavulanate (Augmentin) was prescribed for 14 days. Urine culture subsequently grew Proteus mirabilis (>100,000 CFU/mL), confirming CAUTI. Symptoms improved on follow-up without complications, and the purple discolouration resolved after catheter replacement. Conclusion: This case highlights PUBS as a valuable visual indicator of CAUTI in patients with neurogenic bladder and delayed catheter changes. Early recognition, timely catheter replacement, and targeted antibiotic therapy are essential to prevent complications in high-risk primary care patients.
| Item Type: | Proceeding Paper (Poster) |
|---|---|
| Uncontrolled Keywords: | PUBS, UTI, neurogenic bladder |
| Subjects: | R Medicine > R Medicine (General) |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine > Department of Family Medicine (Effective: 1st January 2011) Kulliyyah of Medicine |
| Depositing User: | Prof Dr Mohd Aznan Md Aris |
| Date Deposited: | 30 Jul 2026 15:19 |
| Last Update: | 30 Jul 2026 15:19 |
| Queue Number: | 2026-07-Q4347 |
| URI: | http://irep.iium.edu.my/id/eprint/130308 |
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