Basehi Mohammed F, Dallak Fatimah H, Darraj Atheer I, Almalki Sultan J
Emergency Department, King Fahd Central Hospital, Jazan Health Cluster, Jazan, Saudi Arabia.
Internal Medicine Department, King Fahd Central Hospital, Jazan Health Cluster, Jazan, Saudi Arabia.
Medicine (Baltimore). 2025 Sep 19;104(38):e44638. doi: 10.1097/MD.0000000000044638.
Purple urine bag syndrome (PUBS) is a rare but visually alarming condition associated with urinary tract infections (UTIs), typically occurring in debilitated elderly patients with long-term indwelling catheters. Awareness of PUBS is essential, as it can serve as an indicator of underlying infection.
Two elderly male patients presented with striking purple discoloration of their urinary catheter bags. Caregivers expressed concern, although both patients denied fever, dysuria, or suprapubic pain.
PUBS secondary to UTI was diagnosed. Case 1 involved mixed bacterial growth, with risk factors including diabetes mellitus, benign prostatic hyperplasia, immobility, and prolonged catheterization. Case 2 had Candida tropicalis infection, with predisposing factors of stroke-related immobility, constipation, and chronic catheterization.
Both patients underwent a Foley catheter and urine bag replacement. Case 1 received empirical oral ciprofloxacin, while case 2 required admission, intravenous antifungal therapy, and supportive hydration.
Purple discoloration resolved after catheter replacement. Both patients achieved favorable outcomes without recurrence.
While PUBS is typically benign, it reflects underlying UTIs and requires prompt intervention. Early recognition, catheter management, and appropriate antimicrobial therapy are key to preventing complications. Clinician awareness is vital to avoid misdiagnosis and unnecessary anxiety.
紫色尿袋综合征（PUBS）是一种罕见但视觉上令人警觉的病症，与尿路感染（UTI）相关，通常发生在长期留置导尿管的体弱老年患者中。认识到PUBS至关重要，因为它可作为潜在感染的一个指标。
两名老年男性患者的导尿管袋出现明显的紫色变色。尽管两名患者均否认发热、排尿困难或耻骨上疼痛，但护理人员表示担忧。
诊断为UTI继发的PUBS。病例1为混合细菌生长，危险因素包括糖尿病、良性前列腺增生、活动不便和长期导尿。病例2为热带念珠菌感染，诱发因素为中风相关的活动不便、便秘和长期导尿。
两名患者均接受了Foley导尿管和尿袋更换。病例1接受经验性口服环丙沙星治疗，而病例2需要住院、静脉抗真菌治疗和支持性补液。
更换导尿管后紫色变色消失。两名患者均取得良好效果，无复发。
虽然PUBS通常是良性的，但它反映了潜在的UTI，需要及时干预。早期识别、导尿管管理和适当的抗菌治疗是预防并发症的关键。临床医生的认识对于避免误诊和不必要的焦虑至关重要。
