Purple Urine Bag Syndrome: Antibiotic Treatment or Not?

Purple urine bag syndrome (PUBS) is a relatively rare phenomenon characterized by purple discoloration of the urine, catheter, and collection bag in individuals with indwelling catheters often colonized by specific bacteria. Although typically asymptomatic, it requires appropriate diagnostic evaluation and, in some cases, targeted treatment. We present a case study of an 81-year-old male with an indwelling urinary catheter who developed an uncomplicated, self-limiting case of purple urine bag syndrome. The patient exhibited the characteristic purple discoloration of the catheter tubing and collection bag, without accompanying systemic symptoms such as fever, dysuria, flank pain, or altered mental status. This case underscores the importance of recognizing PUBS as a benign condition in many instances, to avoid unnecessary diagnostic testing or antibiotic therapy, while still ensuring appropriate clinical evaluation to rule out potential underlying infections or contributing risk factors.