Purple urine is most commonly caused by UTI from certain Klebsiella or Pseudomonas species that break down tryptophan into indole which then interacts with the plastic of the catheter bag producing a purple coating.

Orange urine is most commonly caused by pyridium, rifampin, bile, carrots, rhubarb, sulfa, fluorescein, vitamin A or B12.

Regards

thanks a lot sir.

But the patient didn't have any of these. And urine colour change was noted on 1 st post op day. Cleared on its own with continuation of antibiotics.

klebsiella can produce the purple colour . Our quest is whether it can cause orange colour also?

In the literature, there are no known case reports describing orange-coloured urine due to bacterial overgrowth in the bladder.

Curiously, one case report mentions an infant with orange urine caused by a urinary tract infection (attached). The apparent cause was a Gram-negative bacillus that produces indole from tryptophan.

Regards

Thanks a lot. I also read through the report.the biochemical. Colour change is in the lab only.the organism do not change urine colour. Purple colour is commonly noted- infected urine interacting withpvc.in our case the orange colour disappeared after 12 .hrs.culture grew klebsiella

With thanks

Selvan

The pathogenesis is controversial. According to the most popular hypothesis , dietary tryptophan is converted to indole by gut bacteria, which is further metabolized in the liver to indoxyl sulphate and then excreted in the urine. Constipation favors conversion of tryptophan to indole by gut bacteria.

Once excreted, indoxyl sulphate can be processed by bacteria colonizing the urinary catheter to indoxyl, which is further converted to indigo (blue) and indirubin (red). ( Initially had red tinged urine which became orange as urine flowed)

The most commonly involved

bacteria are Providencia stuartii, Providencia rettgeri, Escherichia coli, Klebsiella pneumoniae,( like our patient) Proteusmirabilis, Morganella morganii, Pseudomonas aeruginosa, and Enterococcus species [4]. These bacteria produce indoxyl phosphatase and sulphatase enzymes.

so it solves our puzzle!!