- Blackwater fever
Blackwater fever is a complication of
malaria characterized by intravascularhaemolysis , haemoglobinuria andkidney failure . Blackwater fever is caused by heavy parasitization of red blood cells with "Plasmodium falciparum ". There has been at least one case, however, attributed to "Plasmodium vivax ". [ [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1833024 Blackwater fever caused by Plasmodium vivax infection in the acquired immune deficiency syndrome ] ]Presentation
Within a few days of onset there are chills, with rigor, high
fever ,jaundice , vomiting, rapidly progressiveanemia and the passage of dark red or black urine.The cause of hemolytic crises in this disease is unknown. There is rapid and massive destruction of
red blood cell s (RBCs) with the production ofhemoglobinemia (hemoglobin in the blood, but outside the RBCs),hemoglobinuria (hemoglobin in urine), intense jaundice,anuria (passage of less than 50 milliliter of urine in a day), and finally death in the majority of cases.The most probable explanation for blackwater fever is an autoimmune reaction.
Treatment
The treatment is antimalarial chemotherapy,
intravenous fluid and sometimes supportive care such asintensive care anddialysis .Blackwater fever is a serious complication of malaria, but
cerebral malaria has a highermortality rate . Blackwater fever is much less common today than it was before 1950. [cite journal |author=Bruneel F, Gachot B, Wolff M, "et al" |title= [Blackwater fever] |language=French |journal=Presse médicale (Paris, France : 1983) |volume=31 |issue=28 |pages=1329–34 |year=2002 |pmid=12355996 |doi=] It may be thatquinine plays a role in triggering the condition, and this drug is no longer commonly used for malariaprophylaxis . Quinine remains important for treatment of malaria.Cultural references
* "Out of Africa", a film based on the experiences of author
Isak Dinesen .
* "At Play in the Fields of the Lord ," a novel byPeter Matthiessen .
* "West with the Night ", African memoir by aviatrixBeryl Markham .
* "Burmese Days ", a novel byGeorge Orwell ; several associates of Flory are noted to have died of blackwater fever in chapter 5.
* "The Heart of the Matter ", a novel byGraham Greene .References
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