Green Urine: What is the Culprit?

Siwadon Pitukweerakul MD, Sree Pilla MD,MPH, Sai Prasad Gadapa MD

July 29, 2016

A 51 year-old man was brought to emergency department for altered mental status. His wife reported that he used cocaine 5 hours before he was found unresponsive.  Past medical history included hypertension and cocaine abuse. He was intubated for respiratory depression. On admission, the laboratory results revealed cocaine in his urine. Urinalysis was unremarkable. He developed acute respiratory distress syndrome and became agitated. 2 mg/kg/h of propofol was started. Green urine was found in urine bag (Figure 1) 42 hours after propofol infusion began. 

Siwadon Pitukweerakul MD, Sree Pilla MD,MPH, Sai Prasad Gadapa MD:
Department of Medicine:  Presence Saint Francis Hospital, Evanston, IL