# Chromaturia and Providencia: A Case Report on Purple Urine Bag Syndrome

## TL;DR

A 54-year-old man with a urinary catheter developed purple urine due to a bacterial infection, highlighting the importance of recognizing and managing this rare condition.

## Contribution

This case report adds to the clinical understanding of Purple Urine Bag Syndrome and emphasizes the role of Providencia rettgeri in its pathogenesis.

## Key findings

- Purple urine discoloration was confirmed to be caused by Providencia rettgeri.
- PUBS was managed with antibiotics, catheter replacement, and addressing risk factors.
- The case underscores the need for early recognition of PUBS to prevent complications.

## Abstract

Purple urine bag syndrome (PUBS) is an uncommon condition typically observed in chronically ill, catheterized patients. This case report describes a 54-year-old Indian man with a history of recurrent strokes and long-term urinary catheterization who presented with lower abdominal discomfort and purple discoloration of the urine. Microbiological analysis revealed Providencia rettgeri, confirming the diagnosis of PUBS. The pathogenesis of PUBS involves the interaction between tryptophan and bacterial enzymes, resulting in the formation of colored compounds. Early identification of PUBS facilitates timely management, including treatment of the underlying urinary tract infection with appropriate antibiotics, catheter replacement, and addressing modifiable risk factors, which collectively may prevent potential complications and improve patient outcomes. This case highlights the importance of recognizing PUBS as a clinically relevant indicator of underlying urinary tract infections (UTIs) and emphasizes the need for enhanced care protocols in vulnerable populations. Increased awareness and expeditious management by health care providers can mitigate the impact of this condition.