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[Blackwater fever].

F Bruneel1, B Gachot, M Wolff

  • 1Clinique de réanimation des maladies infectieuses, Hôpital Bichat-Claude Bernard, Paris. fbruneel@ch-versailles.fr

Presse Medicale (Paris, France : 1983)
|October 3, 2002
PubMed
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Blackwater fever, a severe hemolytic anemia, re-emerged with quinine use due to drug resistance. Prompt intensive care ensures good prognosis, with recovery typically without lasting effects.

Area of Science:

  • Malariology
  • Hematology
  • Pharmacology

Background:

  • Blackwater fever is acute intravascular hemolysis linked to quinine in malaria-endemic areas.
  • It presents with severe anemia, jaundice, fever, and acute kidney injury due to tubular necrosis.
  • The condition became rare with chloroquine but resurged due to antimalarial resistance.

Purpose of the Study:

  • To describe the clinical presentation, historical context, and modern management of blackwater fever.
  • To elucidate the potential mechanisms of hemolysis induced by quinine and related drugs.
  • To highlight the current prognosis and outcomes for patients with blackwater fever.

Main Methods:

  • Literature review of historical and contemporary case reports.
  • Analysis of clinical features and laboratory findings.

Related Experiment Videos

  • Discussion of physiopathogenesis and treatment implications.

    • Main Results:

    • Blackwater fever is characterized by severe hemolytic anemia and acute renal failure.
    • Re-emergence linked to quinine use driven by chloroquine resistance.
    • Amino-alcohols like halofantrine and mefloquine also implicated.
    • Successful management often requires intensive care unit admission.

    Conclusions:

    • Blackwater fever is a serious but treatable condition.
    • Understanding drug resistance patterns is crucial for prevention.
    • Modern intensive care improves patient outcomes significantly.