A rare presnetation of uti purple colour bag syndrome

It is a rare condition by intense purple discoloration of urine bag. Although typically 'benign'. Purple urine is not only alarming to patient , but can signal the presence of a UTI that needs a prompt treatment. The interaction between bag(plastic) and pigments and high bacterial load is important in precipitating the PUBS. Several bacteria mostly gram negative, which have been associated with PUBS are Providential Stuartii, providentiarettegri, klebsiellapneumoniae, Proteus mirabilis, E.Coli. Elderly and bedridden patients with multiple comorbities more often require indwelling catheters which increase their risk of UTI .Dehydration increases the serum concentration of indigo and indirubin, hence purple urine is more likely. A greater urinary bacterial load during UTI will obviously increase the availability of bacterial sulphates and phosphates which convert indoxyl sulphate to indigo and indirubicin. Renal failure increases the risk of PUBS because there is impaired clearance of indoxyl sulphate. PUBS is a rare complication of UTI that commonly occurs in elderly women, chronically catheterised bedridden patients, constipation with co-morbidities. It is alarming and concerning for patients, families, Doctors but relatively harmless but needs treatment. this is a spot diagnosis but can be confirmed by history, examination, and urinary investigations. There is significant morbidity and mortality can be associated if not treated. Treatment should target UTI with appropriate antibiotic regimen to prevent sepsis.