Atypical presentation urinary infection: Clinical case and literature review
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Urinary tract infection
Alkaline urine
Purple urine
Gram-negative bacterial infections

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Buitrago Rojas MC, Rozo Ortiz EJ, Vargas Rodríguez LJ, Acosta Pérez CA, Pacheco Olmos BS, Pinilla Vivas LM. Atypical presentation urinary infection: Clinical case and literature review . Rev. Colomb. Nefrol. [Internet]. 2022 Dec. 9 [cited 2024 Jul. 18];9(3). Available from:


Background: Purple urine syndrome is a rare clinical presentation in the emergency room, characterized by abnormal colouration of the urine secondary to a chemical reaction of some pathogens that cause urinary tract infection, being more frequent in patients with multiple comorbidities and different risk factor's.

Purpose: The objective of the article is present the case of a patient with atypical symptoms of urinary tract infection.

Clinical case: An 88-year-old male, with a history of non-insulin diabetes mellitus, benign prostatic hyperplasia, who was admitted to the emergency room due to irritative urinary symptoms associated with the use of a urinary catheter, with purple urine in a collection bag. Urine culture reported the presence of multisensitive Proteus vulgaris, for which it was decided to give treatment with Cefepime 1 g every 8 hours, with which it was obtained with adequate clinical evolution.

Conclusions: Purple urine bag syndrome is an atypical but very striking clinical presentation of urinary tract infection. This is generated as a result of the conversion of tryptophan in the diet into indoxyl sulfate, which, once it is eliminated in the urine, transforms into indigo (purple color) and indirubin (red color), giving this clinical appearance.
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