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Purple urine bag syndrome in palliative care
  1. Sanhapan Wattanapisit1,
  2. Apichai Wattanapisit2,3,
  3. Anong Meepuakmak1 and
  4. Pornnipa Rakkapan1
  1. 1 Palliative Care Unit, Thasala Hospital, Thasala, Nakhon Si Thammarat, Thailand
  2. 2 School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, Thailand
  3. 3 Walailak University Hospital, Thasala, Nakhon Si Thammarat, Thailand
  1. Correspondence to Dr Apichai Wattanapisit, School of Medicine, Walailak University, Thasala, Nakhon Si Thammarat, 80160, Thailand; apichai.wa{at}


Purple urine bag syndrome (PUBS) is a rare condition characterised by urine discolouration. The management of PUBS remains controversial. Four females (mean age 84.5±9.7 years) with palliative conditions (two cancer and two non-cancer cases) presenting PUBS were identified. Urine bags were changed in all cases. Urinary catheters were changed in three cases. Oral antibiotics were prescribed in two cases and used in one case. Urine discolouration was resolved in all cases. One patient (without antibiotic treatment) died on day 5 after presentation of PUBS. Three patients (one out of three cases used oral antibiotics) were clinically stable after the management of PUBS. There was no recurrence of PUBS. Caring for patients with PUBS should be based on clinical decisions, patient status and the goals of care. Palliative care teams should focus on the prevention of PUBS by shortening the duration of catheterisation and minimising modifiable risk factors for this condition.

  • home care
  • palliative care
  • purple urine bag syndrome
  • urinary catheterisation

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  • Contributors SW, AM and PR were responsible for clinical information. SW and AW summarised the information and drafted the manuscript. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Next of kin consent obtained.

  • Provenance and peer review Not commissioned; internally peer reviewed.