Woman with red urine: hydroxocobalamin-induced chromaturia.

A 92-year-old African-American woman suffered from smoke inhalation during ahousefire.Thepatientwas transferred from a cross-town hospital to receive hyperbaric oxygen (HBO) therapy for carbon monoxide intoxication. Before arrival shewas sedated, intubated, and administered hydroxocobalamin (CyanoKit ; King Pharmaceuticals, Bristol, TN) 5 g intravenously for presumed cyanide poisoning. In the Emergency Department (ED) a Foley catheter was placed and, upon inspection, her urine was tinted a deep red color (Figure 1). The patient received promptHBO treatment andwas transferred to the Intensive Care Unit. The extended duration of hydroxocobalamininduced chromaturia can bemeasured by viewing the urine collection bag on day 8 (Figure 2). Despite mechanical ventilation, HBO therapy, and treatment for cyanide toxicity, the patient suffered cardiopulmonary arrestwhile in the Intensive Care Unit and passed away days later.