Purple Urine Bag Syndrome: A Case Report

Purple Urine Bag Syndrome (PUBS) is a rare and often under recognized phenomenon where a urine collection bag turns a distinct purple or blue hue.This condition is typically associated with urinary tract infections (UTIs) in patients with long-term indwelling catheters.There have been few reported cases.In this report, I present an 82-year-old male, A.A., who was admitted to the hospital with worsening bilateral hip pain and leg weakness following a fall and a series of imaging tests that showed mild atelectasis, unremarkable knee findings, and degenerative lumbar disease but no fractures.Despite initial assessments indicating no immediate intervention was needed, his symptoms escalated, leading to difficulty walking and reduced intake of food and fluids.The patient had a significant medical history including stage IV CKD and prostate cancer with multiple surgeries.During hospitalization, he developed PUBS and lab tests showed cloudy urine with signs of bacteria but no definitive UTI.He also experienced altered mental status, likely from acute metabolic encephalopathy due to worsening renal function.Ceftriaxone was started with some improvement noted, but the patient's condition continued to decline likely due to his progression of metastatic cancer, leading to a transfer to comfort care where he passed away a few days later.The resolution of PUBS could not be fully assessed due to the transition to comfort care.This case aims to highlight the importance of recognizing and familiarizing healthcare providers about this rare syndrome.