Clinical Image

Purple Urine Bag Syndrome

Ganesh Kasinathan*
Department of Internal Medicine, Segamat Hospital, Malaysia

*Corresponding author: Ganesh Kasinathan, Department of Internal Medicine, Segamat Hospital, KM 6 Jalan Genuang, 85000 Segamat, Johor, Malaysia

Published: 12 Aug, 2016
Cite this article as: Kasinathan G. Purple Urine Bag Syndrome. Ann Clin Case Rep. 2016; 1: 1080.


A 70 year old lady of recurrent ischaemic stroke on a chronic urinary catheter presented with purple discoloration of her catheter bag. Clinically, she was febrile. The urinary catheter drainage bag (Panel A) was purple stained. Her urine pH was alkaline at 7.5 with leucocytes present. The urine culture grew Klebsiella pneumoniae. She was treated with ampicillin/sulbactam which led to the resolution of her purple urine bag. The purple discoloration of the catheter bag is due to the blue pigment indirubin and purple pigment indigo [1]. The pigment production is thought to be the result of altered metabolism of tryptophan [2].


  1. Peter Peters, Jessica Merlo, Nicholas Beech, Chantelle Giles, Bonita Boon, Brian Parker, et al. The purple urine bag syndrome: a visually striking side effect of a highly alkaline urinary tract infection. Can Urol Assoc J. 2011; 5: 233–234.
  2. Chi-Hung Lin, Hsien-Te Huang, Chia-Chang Chien, Dong-Sheng Tzeng, For-Wey Lung. Purple urine bag syndrome in nursing homes: Ten elderly case reports and a literature review. Clin Interv Aging. 2008; 3: 729-734.