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The urinary sediment and urine bags of 2 cases of PUBS were observed by LVSEM. The urine was brown turbid urine with a pH of 8.5, and magnesium phosphate stones and granules were observed in the urinary sediment together with Gram-positive and Gram-negative bacilli. Bacteria that moved by Brownian motion were observed with a dark-field microscope. LVSEM showed granular crystals around the bacilli, cocci, or mycelium that adhered to the walls of the bag. Granular crystals were dissolved in chloroform and presumed to be a mixture of the bacterial metabolites indigo blue and indirubin red. LVSEM also detected unusual tubular and honeycomb-like graphene in the urinary sediments, which were derived from the inner layer of the silicon elastomer-coated rubber catheter. LVSEM revealed purple crystals produced by bacteria or fungi attached to the urine bag that caused PUBS.<\/jats:p>","DOI":"10.1007\/s00795-022-00313-0","type":"journal-article","created":{"date-parts":[[2022,2,4]],"date-time":"2022-02-04T17:26:47Z","timestamp":1643995607000},"page":"123-130","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Analysis of purple urine bag syndrome by low vacuum scanning electron microscopy"],"prefix":"10.1007","volume":"55","author":[{"given":"Makoto","family":"Abe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahito","family":"Furuichi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiko","family":"Ishimitsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9315-7546","authenticated-orcid":false,"given":"Akihiro","family":"Tojo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,2,4]]},"reference":[{"key":"313_CR1","doi-asserted-by":"publisher","first-page":"883","DOI":"10.1016\/S0140-6736(78)90239-8","volume":"1","author":"NR Buist","year":"1978","unstructured":"Buist NR (1978) Purple urine bags. 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