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?
The urine is green!
What are some possible causes?
Causes of green urine include IV or oral administration of products containing phenol, chlorophyll or thymol
- Methylene blue
- Magnesium Salicylate
- Carbolic Acid
- Flavine derivatives
- Indigo Blue
- Methylene Blue
- Pseudomonas Infection
- Hartnup disease
- Indicanemia and Indicanuria
- 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
Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |