LITFL » Arcanum Veritas » How Green is my…urine

How Green is my…urine

November 5, 2009 By 5 Comments

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…

In case your mind is clouded with non-medical perturbations I have taken the liberty of outlining some of the more common causes below

Unusual Urine 002

Unusual Urine 002

Green Urine 001

Green Urine 008

Questions

What is unusual about the appearance of the urine?

The urine is green!

What are the possible causes?

Causes of green urine include IV or oral administration of products containing phenola, chlorophyllb or thymolc

  • Drugs
    • Cimetidine i.v. (Tagamet)a
    • Promethazine i.v. (Phenergan)a
    • Amitriptyline (Elavil)
    • Flutamide (Eulexin)
    • Indomethacin (Indocid)
    • Methocarbamol (Robaxin)
    • Methylene blue
    • Mitoxantrone (Novantrone)
    • Propofol (Diprivan)
    • Phenylbutazone
    • Triamterene (Dyrenium)
  • Consumer Products
    • Cloretsb
    • Listerinec
    • Magnesium Salicylate
    • Asparagus
  • Dyes
    • Carbolic Acid
    • Flavine derivatives
    • Indigo Blue
    • Methylene Blue
    • Resorcinol
  • Pathologic Conditions

References

ResearchBlogging.org

  • Riker RR, Glisic EK, & Fraser GL (2009). Propofol infusion syndrome: difficult to recognize, difficult to study. Critical care medicine, 37 (12), 3169-70 PMID: 19923937
  • Iyer VN, Hoel R, & Rabinstein AA (2009). Propofol infusion syndrome in patients with refractory status epilepticus: an 11-year clinical experience. Critical care medicine, 37 (12), 3024-30 PMID: 19661801
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Filed Under: Arcanum Veritas, Investigation [tests], Urinalysis, What the Tagged With: , , , ,
About Mike Cadogan

Emergency physician with a passion for medical informatics and medical education. Co-founder of HealthEngine, iMeducate, and the GMEP. He writes more eclectically on the web as @sandnsurf | + Mike Cadogan | Contact

Comments

  1. sandnsurf says:
    November 5, 2009 at 8:18 am

    I have most commonly see green urine associated with prolonged propofol sedation. In this case the virescent urinary hue was secondary to an overdose of Crème de menthe

    Reply
  2. Rogue Medic says:
    November 5, 2009 at 9:16 am

    Quite the sweet tooth. Any history of diabetes?

    What was alcohol level?

    Reply
  3. Jabulani says:
    November 5, 2009 at 1:15 pm

    I’ve never seen green before, but pinky red yes. It happens in my children after they’ve consumed either cranberry or blackcurrant juice. And during blackberry season when we go picking, they have to sample a few … well, several actually. Ok, LOTS…!! I tell them I can count how many they’ve had by the colour of their urine. So far, they think I’m magic :)

    Reply
  4. Francesca says:
    November 6, 2009 at 9:12 am

    Would have thought super green supplement foods like alfalfa, spirulina, etc. Crème de menthe…who would have known?! Nice cases you get over there.

    Reply

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