5.0 of 3 Ratings
A 25-year-old Greek college student presents to the emergency department with wine-colored urine. He states that the change in urine color came on suddenly, and this has never happened to him before. Aside from the dark urine, he complains of minor muscle pain and soreness that is related to his training. The patient states he ran in a marathon today that he has been training for for the past year. The patient does not have a significant past medical history and is currently taking a multivitamin, fish oil, and a whey protein supplement. Urine dipstick is positive for red blood cells. An EKG is obtained and seen in Figure A. Urine toxicology is performed and returns positive for amphetamines and cocaine. On physical exam, you note an excitable young man who has no abnormal findings. Urine microscopy reveals an absence of red blood cells. Which of the following is the next best step in management?
Observation and wait for the patient to metabolize illicit substances
Phlebotomy and chloroquine
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