Purple urine bag syndrome: a rare presentation of Fournier’s Gangrene, A Case Report

Abstract

A change in urine color could be shocking to the patient, as well as to the healthcare workers, especially when it turns to a color they are not familiar with. Purple urine stems from urinary infection with bacteria capable of producing sulphatase/phosphatase enzymes that break down tryptophan substances in alkaline medium to indigo and indirubin. The latter combination tinges the urine with a frightening purple color known as “purple urine bag syndrome” (PUBS).  The syndrome is rare and never reported in association with Fournier’s gangrene. PUBS bacteria include E. coli and Proteous mirabilis. Despite the fact that PUBS appearance with a graphic appearance of a urine bag, it is a benign condition. Reassurance is crucial to allay patient's concerns.

A 48-year-old man was presented to the emergency room with a full-blown picture of Fournier's gangrene. A urinary catheter was inserted and drained purple urine. He wasn't febrile at the presentation. However, I was constipated on the days leading to the hospital show. The patient is not diabetic, and not a smoker.

The patient was admitted and treated with culture-based antibiotics after a thorough surgical debridement. He developed Acinetobacter baumannii in wound culture that was multi-drug resistant. He survived the critical phases and was released from the hospital on every-other-day dressing.