A 50-year-old man was found to have purple discoloration of the urine. He was on long-term urinary catheterization. He was asymptomatic, and urinalysis did not suggest a urinary tract infection. Purple urine bag syndrome resolved with a change of the urinary catheter and bag. He was prescribed regular laxatives and passed stools regularly.
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Purple Urine Bag Syndrome as a Visual Trigger for Overtreatment: A Case Report and Aggregated Literature Analysis Micah Pippin, Yashwanth Ramineni Damodhar, Sanjay Shrestha Cureus.2026;[Epub] CrossRef
Purple urine bag syndrome: An unusual presentation of urinary tract infection: A case series and literature review Mohammed F. Basehi, Fatimah H. Dallak, Atheer I. Darraj, Sultan J. Almalki Medicine.2025; 104(38): e44638. CrossRef
Violet discoloration of urine: A case report and a literature review Muthanna Saraireh, Sahem Gharaibeh, Mohammad Araydah, Sarah Al Sharie, Fadi Haddad, Arqam Alrababah Annals of Medicine and Surgery.2021; 68: 102570. CrossRef
Diagnoses of pyelonephritis caused by Staphylococcus aureus should be accompanied by investigations of concomitant bladder obstruction and metastatic infections, especially to the spine or heart. Complicated pyelonephritis due to S. aureus requires more than 2 weeks of antibiotics, which is the typically recommended treatment duration for pyelonephritis. We describe a patient who was diagnosed with complicated epidural and paraspinal abscesses after insufficient evaluation and treatment of acute pyelonephritis due to S. aureus. A 62-year-old man with type 2 diabetes was admitted with fever, increased urinary frequency, and left flank pain. He was diagnosed with acute pyelonephritis caused by S. aureus. His fever and flank pain subsided after 3 days of intravenous antibiotics. Evaluation of bladder obstruction and metastatic infection were not performed, as he declined further evaluation. The patient was discharged with oral antibiotics and was requested to attend weekly appointments but was lost to follow-up. One month later, the patient presented at the outpatient clinic with similar symptoms. Computed tomography showed recurrent pyelonephritis and a distended bladder. His flank pain persisted despite administration of an opioid agent. Therefore, magnetic resonance imaging was performed, revealing epidural and paraspinal abscesses. Ultrasound-guided aspiration of the paraspinal muscle layer was performed, and blood and percutaneous aspirated fluid cultures revealed S. aureus growth. The pattern of antimicrobial sensitivity was identical to that at his first admission. Following more than 4 weeks of antibiotics, magnetic resonance imaging showed the abscesses had decreased in size. The patient was discharged without neurologic sequelae and was provided with oral antibiotics.
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A Case Presenting with a Paraspinal Muscle Abscess Complicated by Suspected Iodoform Poisoning During Treatment Shunya Tamamine, Atsuyuki Kuro, Masayuki Nakano, Shuhei Matsunami, Hiroaki Sakurai, Sakurako Kunieda, Kenji Suzuki, Natsuko Kakudo International Journal of Surgical Wound Care.2025; 6(2): 64. CrossRef
Spinal epidural abscess due to acute pyelonephritis Gianluca Scalia, Salvatore Marrone, Federica Paolini, Paolo Palmisciano, Giancarlo Ponzo, Massimiliano Giuffrida, Massimo Furnari, Domenico Gerardo Iacopino, Giovanni Federico Nicoletti, Giuseppe Emmanuele Umana Surgical Neurology International.2022; 13: 159. CrossRef
Primary Spinal Epidural Abscesses Not Associated With Pyogenic Infectious Spondylodiscitis: A New Pathogenetic Hypothesis Lorenzo Magrassi, Marco Mussa, Andrea Montalbetti, Marta Colaneri, Angela di Matteo, Antonello Malfitano, Anna Maria Simoncelli, Maria Grazia Egitto, Claudio Bernucci, Enrico Brunetti Frontiers in Surgery.2020;[Epub] CrossRef
Background : The overuse and misuse of antimicrobial agents and their resultant emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. Therefore, a new system that separated prescribing and dispensing medicine began on July 1, 1997 to prevent overuse and misuse of medicine. We studied to evaluate changes of antibiotic sensitivities to causative microorganisms of urinary tract infection 2 years before and after the new medical system.
Methods : During each 2 years before and after the new medical system, we analyzed antibiotic sensitivities of causative microorganisms for urinary tract infection among the 447 outpatients who visited a hospital in GangNeung. The diagnosis of urinary tract infection was based on greater than 105 CFU (Colony For Unit) per ml urine.
Results : The most common pathogenic microorganisms as E.coli (76.5%), followed by Klebsiella pneumoniae (5.1%), and Proteus mirabilis (3.6%) in urine culture. A first generation cephalosporin, cephalothin, against E.coli, had more significant sensitivity after the introduction of the new medical system (52.6%) than before (33.9%), especially in the 8th decade (P=0.023) and in females (P＜0.001). Also, trimethoprim/sulfamethoxazole against E.coli showed signifcant improving sensitivity (P=0.025).
Conclusion : There was little change of antibiotic sensitivity of urinary tract infection in outpatients before and after the new medical system in cephalothin and trimethoprim/sulfamethoxazole against E.coli. The change of antibiotic sensitivities will require further observation for a longer term after the introduction of the new medical system.
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