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When is red urine not hematuria?: A case report
Jason S Bryant1, Marianne Gausche-Hill
1Department of Emergency Medicine, Kaiser Permanente Medical Center, Santa Clara, California 95051, USA.
The Journal of Emergency Medicine
|January 24, 2007
Summary
Red urine after trauma can indicate genitourinary issues, but this case highlights a rare cause: topical sulfa ointment. This emphasizes the importance of considering drug-induced pigmenturia in emergency evaluations.
Area of Science:
- Urology
- Emergency Medicine
- Toxicology
Background:
- Gross hematuria, visible blood in urine, often suggests genitourinary trauma.
- Trauma patients presenting with red urine typically undergo evaluation for serious injury.
Observation:
- A 19-year-old male presented with gross hematuria following a motorcycle accident.
- Initial assessment focused on potential genitourinary trauma due to the visible blood in urine.
Findings:
- The patient's red urine was not due to hematuria but pigmenturia.
- The discoloration resulted from a topical sulfa ointment containing an azo dye, obtained in Mexico.
Implications:
- This case underscores the importance of a broad differential diagnosis in emergency medicine.
- Clinicians must consider drug or food-induced pigmenturia, especially with alternative medicine use, to avoid misdiagnosis and unnecessary interventions.
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