Purple urine bag syndrome in palliative care

BMJ Support Palliat Care. 2019 Jun;9(2):155-157. doi: 10.1136/bmjspcare-2018-001601. Epub 2018 Jul 25.

Abstract

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.

Keywords: home care; palliative care; purple urine bag syndrome; urinary catheterisation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use*
  • Female
  • Humans
  • Indigo Carmine / urine*
  • Indoles / urine
  • Palliative Care / methods*
  • Treatment Outcome
  • Urinary Catheterization / adverse effects*
  • Urinary Tract Infections / drug therapy*
  • Urinary Tract Infections / etiology*

Substances

  • Anti-Bacterial Agents
  • Indoles
  • Indigo Carmine
  • indirubin