Verdoglobinuria

Abstract

A green colored urine was noted in burned patients dying of Gram negative septicemia, particularly that of Pseudomonas. The responsible pigment was identified as verdoglobin, an intermediary product of hemoglobin catabolism in the reticulo-endothelial system. It is postulated that absorbed Pseudomonas toxin inhibits the reticuloendothelial system, thereby permitting accumulation of verdoglobin and its excretion in the urine. Immunologic studies suggest that the associated hemolytic anemia is mainly the result of Pseudomonas hemolysins and not of an autoimmune process. Verdoglobinuria was detectable by ultraviolet fluorescence many days prior to its recognition in ordinary light. This should permit more detailed study of Pseudomonas septicemia, as well as recognition at a stage when the patient is not terminal.