Purple Urine Bag Syndrome
An 86-year-old woman had a history of osteoporosis and bilateral fracture of neck femur for two years. Her daily activity was limited and she was bedridden most of the day. She could sit for a while with a caregiver's help [].\nShe had Foley catheterization for one year because of neurogenic bladder. She was also suffering from constipation from her early age and it became severe enough in last two years. Urine with purple sediment was found in the urine bag one day before admission [].\nShe did not have fever or a history of drug administration before admission. The patient had a history of recurrent urinary tract infections (UTIs) in the past. Physical examination revealed diffuse tenderness on palpation of the abdomen. Other examinations did not indicate any other noteworthy symptoms. The urinalysis showed alkaline urine with the urinary sediment contained 5-7 white blood cells/high-power-field. She was admitted under the impression of urinary tract infection and constipation. The patient was empirically started on oral cefuroxime. Urine cultures yielded Escherichia Coli and growth was greater than 105/mL. The antibiotic therapy was changed to ceftriaxone 1 gm intravenous injection every day and gentamicin 80 mg intravenous injection 8 hourly according to antibiotic sensitivity tests of the urine cultures. A glycerol containing oral preparation was given for her constipation. The Foley catheter was also changed. The purple urine disappeared and the following urinalysis was sterile. She was discharged in stable condition.