JAMA Clinical Challenge

Purple Urine

Patient urine on admission.

Eli Ben-Chetrit, MD
Gabriel Munter, MD
An elderly frail woman with dementia was admitted to the internal medicine service because of malfunction of her percutaneous gastrostomy tube. The patient had a history of recurrent hospitalizations for pneumonia and urinary tract infections. She had a permanent indwelling urinary catheter because of repeated episodes of urinary retention. The gastrostomy tube was replaced.

During admission a nurse noticed that the color of the urine was purple (Figure). A urine dipstick analysis revealed +2 leukocytes, +1 red blood cells, positive nitrites, and a urinary pH of 8.2.

See the full article for an explanation and discussion.

Author Affiliations: Dr Ben-Chetrit (elibc1{at}yahoo.com) is affiliated with the Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel. Dr Munter is affiliated with the Department of Internal Medicine, Shaare Zedek Medical Center, Hebrew University School of Medicine, Jerusalem, Israel.