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Case Reports
. 2025 Jun 25;17(6):e86725.
doi: 10.7759/cureus.86725. eCollection 2025 Jun.

Purple Urine Bag Syndrome: Antibiotic Treatment or Not?

Gunnhild Helmsdal  1
Affiliations
Case Reports

Purple Urine Bag Syndrome: Antibiotic Treatment or Not?

Gunnhild Helmsdal. Cureus. .

Abstract

Purple urine bag syndrome (PUBS) is a relatively rare phenomenon characterized by purple discoloration of the urine, catheter, and collection bag in individuals with indwelling catheters often colonized by specific bacteria. Although typically asymptomatic, it requires appropriate diagnostic evaluation and, in some cases, targeted treatment. We present a case study of an 81-year-old male with an indwelling urinary catheter who developed an uncomplicated, self-limiting case of purple urine bag syndrome. The patient exhibited the characteristic purple discoloration of the catheter tubing and collection bag, without accompanying systemic symptoms such as fever, dysuria, flank pain, or altered mental status. This case underscores the importance of recognizing PUBS as a benign condition in many instances, to avoid unnecessary diagnostic testing or antibiotic therapy, while still ensuring appropriate clinical evaluation to rule out potential underlying infections or contributing risk factors.

Keywords: antibiotic resistance; indwelling catheter; pubs; purple urine bag syndrome; urinary tract infection.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Dark brown urine and purple discoloration of the urine bag and catheter
Figure 2
Figure 2. After changing the catheter and urine bag, the color of the urine normalized in less than a day
See this image and copyright information in PMC

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