[Blackwater fever: a case report]

The first case of blackwater fever was reported in Cuban medical literature. It is an uncommon complication of paludism due to Plasmodium falciparum, characterized by fever, hemoglobinuria, and kidney failure, with dramatic development and high mortality. The patient came from the People's Republic of Angola, where he stayed 7 years, with history of various episodes of malaria. He was admitted with fever, icterus and thick film test positive for P. falciparum. Treatment with quinine was started, but dark red urine and an increase of icterus were observed 12 hours later. Treatment with quinine was suspended. Red blood cells and platelets were transfused and hemodialysis and plasmapheresis were performed. The patient was discharged 2 weeks later asymptomatic and with negative thick film test. The pathogeny of this disease was discussed, specially kidney failure, making emphasis on the importance of the symptomatic and maintenance treatment in the patient's evolution.