MEDizzy
MEDizzy
Mahdis
Mahdisover 4 years ago
Alkaline urine in end stage renal disease patient

Alkaline urine in end stage renal disease patient

An unbelievable case of purple urine!! A 76-year-old male nursing home resident with dementia and end-stage renal disease who was undergoing hemodialysis was admitted to the hospital after a #syncopal episode that occurred during dialysis. Torsades de pointes was noted on telemetry monitoring. When a urinary catheter was placed, purple urine was drained. The patient had no fever, lower urinary tract symptoms, or #leukocytosis. The urinalysis showed a pH of 9.0 and bacteriuria but no hematuria or pyuria. The urine culture showed 105 colony-forming units or more per milliliter for both Pseudomonas aeruginosa and enterococcus species. Over the next 3 days, the urine gradually became yellow and clear, in the absence of antibiotic treatment. Purple #discoloration can occur in alkaline urine as a result of the degradation of indoxyl sulfate (indican), a metabolite of dietary #tryptophan, into indigo (which is blue) and indirubin (which is red) by #bacteria such as Providencia stuartii, Klebsiella pneumoniae, P. aeruginosa, Escherichia coli, and enterococcus species. The clinical course is benign, and the #urine typically clears with resolution of the bacteriuria and #acidification of the urine. This patient had no further episodes of torsades de pointes and returned to the nursing home in stable condition.

19
Top rated comment
over 4 years ago

This can happen in end stage renal disease.methyline blue also cause bluish coloration of urine.Good presentation šŸ‘. Nice work.

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