Purple urine bag syndrome

A 72-year-old man was admitted to the internal medical ward with the suspicion of a sepsis on top of his metastasised bladder cancer. The home care nurse reported that during the days before admission he had not been eating and barely drinking. Because of increased back pain he had used more morphine, without being able to take laxatives. At physical examination the patient had fever (38.6°C) and a blood pressure of 90/64 mmHg with a pulse rate of 104 beats/min. He was cachectic, dehydrated and constipated and had no clinical focus of infection. Laboratory investigations revealed a white blood cell count of 15.5 x 10 9