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JAMA Clinical Challenge
January 11, 2012

Purple Urine

Author Affiliations

Author Affiliations: Department of Internal Medicine, Shaare Zedek Medical Center, Hebrew University School of Medicine, Jerusalem, Israel.

JAMA. 2012;307(2):193-194. doi:10.1001/jama.2011.1997

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 1). A urine dipstick analysis revealed +2 leukocytes, +1 red blood cells, positive nitrites, and a urinary pH of 8.2.