How Green is my urine
aka Unusual Urine 002
Morning rounds can be fun sometimes…you never know what diagnostic conundrums and eponymous challenges you will face.
Casual perusal of the output from a patients indwelling catheter this morning provoked some consternation amongst the staff, but I have great faith that you will have little trouble in elucidating a comprehensive differential diagnosis for the unusual appearance of the depicted urethral elimination…
What is unusual about the appearance of the urine?
Unusual Answer
The urine is green!
What are some possible causes?
Unusual Answer
Causes of green urine include IV or oral administration of products containing phenol, chlorophyll or thymol
Drugs:
- Cimetidine
- Promethazine
- Amitriptyline
- Flutamide
- Indomethacin
- Methocarbamol
- Methylene blue
- Mitoxantrone
- Propofol
- Phenylbutazone
- Triamterene
Consumer Products
- Clorets
- Listerine
- Magnesium Salicylate
- Asparagus
Dyes:
- Carbolic Acid
- Flavine derivatives
- Indigo Blue
- Methylene Blue
- Resorcinol
Pathologic Conditions:
- Pseudomonas Infection
- Hartnup disease
- Indicanemia and Indicanuria
References
- Riker RR, Glisic EK, Fraser GL. Propofol infusion syndrome: difficult to recognize, difficult to study. Crit Care Med. 2009 Dec;37(12):3169-70
- Iyer VN, Hoel R, Rabinstein AA. Propofol infusion syndrome in patients with refractory status epilepticus: an 11-year clinical experience. Crit Care Med. 2009 Dec;37(12):3024-30
- Pulos BP, Sviggum HP, Sharpe EE. Propofol-associated Green Hair Discoloration. Anesthesiology. 2019 Mar;130(3):445.
- Nickson C. The Art of Observation (particularly Urine). LITFL
- Cadogan M. Verdant waste. LITFL
- Rogers J. Green Urine. LITFL
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Unusual Urine
Clinical cases
