indigo-carmine and Escherichia-coli-Infections

Topics: Aged; Catheters, Indwelling; Escherichia coli Infections; Female; Humans; Indican; Indigo Carmine; Indoles; Polyvinyl Chloride; Urinary Catheterization; Urinary Tract Infections

Purple urine bag syndrome is a rare disorder where the plastic urinary catheter bag and tubing turn purple. The discolouration is due to the presence of indigo and indirubin pigments which are metabolites of tryptophan. It is associated with urinary tract infection. Bacteria that produce sulphatase and phosphatase are involved in the formation of these pigments. Purple urine bag syndrome is associated with higher morbidity and mortality, compared to urinary tract infection without this phenomenon. We present a case report of this rare phenomenon occurring in a 68-year-old woman.

Topics: Aged; Antidepressive Agents, Second-Generation; Escherichia coli Infections; Fatal Outcome; Female; Humans; Indigo Carmine; Indoles; Tryptophan; Urinary Catheterization; Urinary Tract Infections

Discoloration of urine is not uncommonly encountered in clinical practice and may indicate a significant pathology. However, the majority of instances are benign and occur as the result of trauma to the urological system during procedures or ingestions of substances such as medication or food. Purple discoloration of a urinary catheter bag is rare and can be alarming to both patients and healthcare workers. This phenomenon is known as the purple urine bag syndrome. It is associated with urinary tract infections occurring in catheterized patients, generally elderly females with significant comorbidities and constipation. The urine is usually alkaline. Gram-negative bacteria that produce sulfatase and phosphatase are involved in the formation of pigment, indirubin and indigo. Tryptophan metabolism is involved in the pathogenesis. We present two cases of this rare and interesting phenomenon and discuss the underlying pathogenesis.

Topics: Aged; Catheters, Indwelling; Chronic Disease; Constipation; Dehydration; Escherichia coli Infections; Fatal Outcome; Female; Humans; Hydrogen-Ion Concentration; Indigo Carmine; Indoles; Middle Aged; Phosphoric Monoester Hydrolases; Sulfatases; Syndrome; Urinary Catheterization; Urinary Tract Infections