{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:30:55Z","timestamp":1773783055159,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T00:00:00Z","timestamp":1759708800000},"content-version":"vor","delay-in-days":278,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Medicine"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Pleural effusion (PE) is a frequent clinical condition with diverse etiologies including heart failure, infections, and malignancies. While the color of pleural fluid is rarely considered diagnostic, unusual discolorations may offer important clinical clues. We report what appears to be only the third documented case of purple PE (PPE) in the medical literature. This case was associated with\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      infection, a rarely reported cause of PPE, providing additional insight into its potential pathophysiology.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      A 54\u2009year\u2010old obese male with multiple comorbidities\u2014including COPD, heart failure, and recent pulmonary embolism\u2014was admitted with acute respiratory failure. He was found to have a right\u2010sided PE requiring drainage. Initial fluid analysis revealed an exudative, lymphocyte\u2010predominant effusion with no evidence of infection. However, the fluid in the drainage bag gradually turned deep purple, and\n                      <jats:italic>Acinetobacter baumannii<\/jats:italic>\n                      was later isolated from the catheter and collection bag. The patient was treated with colistin and meropenem, with full clinical recovery and resolution of discoloration.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Although the exact mechanism remains unclear, PPE may share pathophysiologic pathways with Purple Urine Bag Syndrome, involving bacterial metabolism of tryptophan\u2010derived compounds. This case highlights the importance of visual inspection of pleural fluid and emphasizes that unusual discoloration\u2014while not diagnostic in itself\u2014should prompt thorough microbiological and biochemical evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>Unusual pleural fluid discoloration should prompt immediate microbiological evaluation, as it may indicate infection with uncommon or multidrug\u2010resistant organisms, even in the absence of typical infection signs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/carm\/6904355","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T12:20:20Z","timestamp":1759753220000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Purple Pleural Effusion due to\n                    <i>Acinetobacter baumannii<\/i>\n                    Infection: A Rare Case Report"],"prefix":"10.1155","volume":"2025","author":[{"given":"Sara","family":"Heidari","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6817-3763","authenticated-orcid":false,"given":"Forough","family":"Kalantari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2494-659X","authenticated-orcid":false,"given":"Elham","family":"Kalantari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_2_10_1_2","volume-title":"Pleural Effusion. StatPearls","author":"Krishna R.","year":"2024"},{"key":"e_1_2_10_2_2","volume-title":"Harrison\u2019s Principles of Internal Medicine","author":"Loscalzo J.","year":"2022"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijpm.ijpm_124_21"},{"key":"e_1_2_10_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2023-255719"},{"key":"e_1_2_10_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/cpm.0000000000000343"},{"key":"e_1_2_10_6_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/3973056"},{"key":"e_1_2_10_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12055-018-0756-6"},{"key":"e_1_2_10_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijscr.2021.106231"},{"key":"e_1_2_10_9_2","doi-asserted-by":"publisher","DOI":"10.1159\/000499281"},{"key":"e_1_2_10_10_2","doi-asserted-by":"publisher","DOI":"10.3390\/toxins8120358"},{"key":"e_1_2_10_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm7090266"},{"key":"e_1_2_10_12_2","doi-asserted-by":"publisher","DOI":"10.3892\/br.2018.1046"}],"container-title":["Case Reports in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/6904355","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/carm\/6904355","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/carm\/6904355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T17:56:53Z","timestamp":1773770213000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/carm\/6904355"}},"subtitle":[],"editor":[{"given":"Takanobu","family":"Hirosawa","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1155\/carm\/6904355"],"URL":"https:\/\/doi.org\/10.1155\/carm\/6904355","archive":["Portico"],"relation":{},"ISSN":["1687-9627","1687-9635"],"issn-type":[{"value":"1687-9627","type":"print"},{"value":"1687-9635","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2025-01-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"6904355"}}