Blue Urine - page 2

Does the patient have a catheter?

My son had green poop once when he was 2, but I've never seen blue urine.

Is this lady being tube-fed? In the old days, to assess for aspiration tube-feed formula would have methylene blue mixed in. I haven't seen it used in tube-feeds for many years. I have had blue urine after a laparoscopic procedure where the surgeon thought he'd nicked my bladder. Methylene blue was instilled through a Foley so he could look for leaks. (Thank God he was wrong... but the blue pee was a bit disconcerting!)

Propofol may cause green urine, but this hospice patient wouldn't be getting propofol.

Several causes can include familial hypercalcemia, an infection w/pseudomonas, or indicanuria (if hospice, labs might be off?)
Abnormal Urine Color - Medical Articles - About Us - Department of Urology - Stanford University School of Medicine
"BLUE / GREEN
Blue or green urine may be caused by a blue dye such as methylene blue, a component in several medications (Trac Tabs, Urised, Uroblue) used to reduce symptoms of bladder inflammation or irritation (1,6). Administration of the dye, indigo carmine, turns the urine green and can last for several days if renal function is poor. While more often reported to cause pink urine, the anesthetic, propofol, has also been reported to cause green coloration of the urine (11). Amitriptyline, indomethacin, resorcinol, triamterine, cimetidine, phenergan, and several multivitamins also lend a blue-green tint to the urine (6). An inherited form of high calcium (called "familial hypercalcemia") can result in blue urine, which has lent this disease the nickname "blue diaper syndrome" (12). Another metabolic disorder, indicanuria, can cause blue urine due to tryptophan indole metabolites (12).

A blue pigment may also be produced by infection with the bacteria Pseudomonas (1,2). Dark green pigmentation, especially if associated with air (known as "pneumaturia"), urinary tract infection, and/or solid particles in the urine, can be caused by bile when there is a fistula between the urinary tract the intestines."

As to the blue pigmentation:
http://textbookofbacteriology.net/pseudomonas_2.html
"One Pseudomonas pigment is probably a determinant of virulence for the pathogen. The blue pigment, pyocyanin, impairs the normal function of human nasal cilia, disrupts the respiratory epithelium, and exerts a proinflammatory effect on phagocytes. A derivative of pyocyanin, pyochelin, is a siderophore that is produced under low-iron conditions to sequester iron from the environment for growth of the pathogen. It could play a role in invasion if it extracts iron from the host to permit bacterial growth in a relatively iron-limited environment. No role in virulence is known for the fluorescent pigments."

It may be proteus mirablis not sure about spelling

Slightly OT: Years ago, my baby sister contracted a horrible UTI on her honeymoon camping in the backwoods of the Upper Peninsula. Honeymoon cystitis it used to be called. The country doc up there gave her Urised but forgot to tell her about the blue urine thing.

That night, she wet the bed in her sleep due to the bladder irritation. Imagine trying to explain THAT to your husband of four days!

My sister had blue poop once when we were little after eating several blue Flinstones push-ups. LOL.

Also, in an episode of Greys Anatomy a pt with Munchausens had bright blue urine. She was taking birth control pills and some kind of herbal supplement I believe.

Yeah Uro Blue.

Usually hospice care patients are under heavy analgesia, my bet is it would be one of those. When you say the pt is taking no medications what do you mean by that?

Mine did the same after eating a six pack of blue Gushers!