The Experts below are selected from a list of 738 Experts worldwide ranked by ideXlab platform
V H Chong - One of the best experts on this subject based on the ideXlab platform.
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Purple Urine Bag syndrome (PUBS): an unusual and rare manifestation of a common condition.
Annals Academy of Medicine Singapore, 2013Co-Authors: V H ChongAbstract:Introduction A 67-year-old lady with background history of type II diabetes mellitus, hypertension, dyslipidaemia and left middle cerebral artery infarction presented to the endoscopy unit with percutaneous endoscopic gastrostomy (PEG) tube dysfunction. The PEG was inserted a year previously after her cerebrovascular accident. She had been fully dependent with her activities of daily living and had been on Ensure feeding supplemented with pureed food made by the family. She was taking glicazide, metformin, enteric coated aspirin, amlodipine and atorvastatin for her conditions. The carer has also noted that her bowel had been infrequent and often small amount and recently had a self-limiting fever. Incidentally, it was noted that her Urine and urinary catheter Bag was discoloured as shown in Figure 1. The family denied giving her any medications or foods other than what she had been given for the previous few months. The family also mentioned that 1 month previously, this had happened and the catheter and Urine Bag was changed by the home-based nursing when they visited for the scheduled nasogastric tube change. What is the cause of the discolouration? A. Haematuria B. Food or food dye C. Urinary tract infection D. Medications E. Porphyria
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purple Urine Bag think of urinary tract infection
American Journal of Emergency Medicine, 2013Co-Authors: Zulkhairi Mohamad, V H ChongAbstract:: Discoloration of Urine can be alarming and may indicate a serious underlying pathology. However, majority is benign and occur as a result of ingestions of substances such as medications or food dye or trauma postinstrumentations. Purple discoloration of the urinary catheter Bag is uncommon and is caused by urinary tract infection with certain organisms. Unfortunately, most clinicians including the frontline clinicians are not aware of this syndrome, and despite the striking features, purple Urine Bag discoloration may be overlooked and not be given appropriate treatment. We present a case of this rare phenomenon with urosepsis that was not diagnosed on 2 occasions when the patient presented to the accident and emergency department.
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purple Urine Bag syndrome
Singapore Medical Journal, 2009Co-Authors: Binu Parameswaran Pillai, V H Chong, A M YongAbstract:: Purple Urine Bag syndrome is a rare disorder where the plastic urinary catheter Bag and tubing turn purple. The discolouration is due to the presence of indigo and indirubin pigments which are metabolites of tryptophan. It is associated with urinary tract infection. Bacteria that produce sulphatase and phosphatase are involved in the formation of these pigments. Purple Urine Bag syndrome is associated with higher morbidity and mortality, compared to urinary tract infection without this phenomenon. We present a case report of this rare phenomenon occurring in a 68-year-old woman.
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purple Urine Bag syndrome a rare and interesting phenomenon
Southern Medical Journal, 2007Co-Authors: Noriko Soffi Harun, Syed Khader Muhammad Shahul Hameed Nainar, V H ChongAbstract:: Discoloration of Urine is not uncommonly encountered in clinical practice and may indicate a significant pathology. However, the majority of instances are benign and occur as the result of trauma to the urological system during procedures or ingestions of substances such as medication or food. Purple discoloration of a urinary catheter Bag is rare and can be alarming to both patients and healthcare workers. This phenomenon is known as the purple Urine Bag syndrome. It is associated with urinary tract infections occurring in catheterized patients, generally elderly females with significant comorbidities and constipation. The Urine is usually alkaline. Gram-negative bacteria that produce sulfatase and phosphatase are involved in the formation of pigment, indirubin and indigo. Tryptophan metabolism is involved in the pathogenesis. We present two cases of this rare and interesting phenomenon and discuss the underlying pathogenesis.
Ana Grilo - One of the best experts on this subject based on the ideXlab platform.
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Case report: Purple Urine Bag syndrome
Critical Care, 2004Co-Authors: Joaquim Palmeiro Ribeiro, Paulo Marcelino, Susan Marum, Ana Paula Fernandes, Ana GriloAbstract:Purple Urine Bag syndrome (PUBS) was first reported in 1978. PUBS is rare, occurs predominantly in constipated women, chronically catheterized and associated with some bacterial urinary infections that produce sulphatase/phosphatase. The etiology is due to indigo (blue) and indirubin (red) or to their mixture that becomes purple. A chain reaction begins in the gastrointestinal tract with tryptophan as described in the article.
George Richard Thompson - One of the best experts on this subject based on the ideXlab platform.
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purple Urine Bag syndrome
Journal of General Internal Medicine, 2011Co-Authors: Craig R Keenan, George Richard ThompsonAbstract:A 97-year-old man presented with complaints of “purple Urine” and constipation. The patient had a chronic indwelling urethral catheter secondary to urinary retention from prostate hyperplasia. Physical examination found a Urine Bag with purple discoloration (Fig. 1). Urine cultures grew Klebsiella pneumoniae. Following treatment with ciprofloxacin, his Urine returned to a normal color. Figure 1 Purple discoloration of urinary Bag and catheter tubing. Purple Urine Bag syndrome (PUBS) is an uncommon disorder in which the Urine Bags of catheterized patients turn purple or blue. First described in 1978, most patients are bedridden, cognitively impaired, and constipated.1 The discoloration is attributed to indigo (blue-violet) and indirubin (red-violet) pigments, which appear purple when combined. The pigments are created when ingested tryptophan is exposed to intestinal flora in patients with altered gut motility. Delayed gut transport allows coliforms to deaminate tryptophan to indole, which is absorbed and conjugated in the liver to indoxyl sulfate. Indoxyl sulfate is then catalyzed by sulfatases or phosphatases in the Urine to indoxyl. Lastly, depending on Urine pH and oxygen concentration, indoxyl is converted to indigo (high pH) and/or indirubin (low oxygen)2,3. PUBS is usually associated with organisms that have indoxyl phosphatase/sulfatase activity (Klebsiella pneumoniae, Providencia stuartii, Enterobacter spp., Proteus mirabilis, Morganella morganii, and Escherichia coli).
Zenyong Chen - One of the best experts on this subject based on the ideXlab platform.
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purple Urine Bag syndrome a community based study and literature review
Nephrology, 2008Co-Authors: Chihchung Shiao, Chingyi Weng, Juichu Chuang, Maosheng Huang, Zenyong ChenAbstract:SUMMARY: Aim: Purple Urine Bag syndrome (PUBS) is considered as an uncommon phenomenon. This cohort study aimed to figure out the causative factors and the potential risks of PUBS. Methods: We recruited 84 patients with long-term urinary catheterization from seven nursing institutions and home care centre, then compared the differences of demographic, clinical, Urine test and bacteriological data between the patients with and without PUBS. Results: The 2-month period prevalence of PUBS in chronic catheterized patients was 16.7%. PUBS-affecting patients had significantly higher proportion of female gender (P = 0.034), self oral intake (P = 0.036) and eating self-prepared food (P = 0.007). Otherwise, no statistical associations were found. Five different bacterial species were isolated from the Urine of PUBS-affecting patients. No sequelae were found after forward follow-up for 6 months. We further discuss the associations between certain factors and PUBS according to literature review and the results of our study. Conclusion: PUBS is not as rare as we thought before. The causative factors of PUBS have not been clearly characterized. It may be the combination of several factors that cause the PUBS. Female gender and food content were found to be associated factors of PUBS in our study. Asymptomatic PUBS is unnecessary to be treated by antibiotics.
Forwey Lung - One of the best experts on this subject based on the ideXlab platform.
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purple Urine Bag syndrome in nursing homes ten elderly case reports and a literature review
Clinical Interventions in Aging, 2008Co-Authors: Hsiente Huang, Chiachang Chien, Dongsheng Tzeng, Forwey LungAbstract:Purple Urine Bag syndrome (PUBS) is a rare occurrence, in which the patient has a purple-colored Urine Bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue) and indirubin (red) that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1%) were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI) with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer’s, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs) has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes.
