UMEM Educational Pearls

Title: What's the Diagnosis? Case by Adeleke Oni, MD

Posted: 12/8/2014 by Haney Mallemat, MD
Click here to contact Haney Mallemat, MD

Question

Patient was found in a house fire and was given a certain medication in the Emergency Room. The patient’s urine turned this color (red), what’s the diagnosis?

Answer

Hydroxocobalamin (i.e., Cyanokit)

Cyanide toxicity

Occurs secondary to combustion of natural and synthetic products producing cyanide
Patients recovered from fires should have a lactate level drawn; levels greater than 10 are concerning for cyanide toxicity.
The Cyanokit contains hydroxocobalamin, a form of vitamin B12 that is used as the antidote.
Hydroxocobalmin has many side-effects including self-limited hypertension, flushing of the skin, and red urine for up to 14 days.
See a previous UMEM post by Dr. Bryan Hayes for more information

References

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