Late methylene blue appearance in urine after local treatment of cutaneous fistula in hip osteomyelitis as a firs sign of renal failure

Methylene blue is a dark green crystal. In medicine it is used as water or alcohol solution. Methaemoglobinemia, hypotension, septic shock are some of many diseases that are treated with methylene blue. In surgery methylene blue is used in diagnostic procedures such as a fistula detection or detection of the parathyroids glands, and for the delineation of certain body tissues during surgery. In patient with normal renal function methylene blue is appearing in urine in a few minutes after intravenous administration. In our patient who was 70 year old we remarked interesting phenomena after we instillation methylene blue into the fistila channel during local treatment of hip osteomyelitis. Methylene blue appeared in urine two days after local treatment, coloring the urine light green and color elimination time was prolonged in few days. These parameters induced as to suspect in renal failure. That was proved after urological, laboratory and radiology examination.