title: [A mild blackwater fever].
abstract: We report a highly probable case of moderately severe blackwater fever. A French woman, living in Guinea Bissau, was used to taking self-medication halofantrine for malaria. On this occasion, she felt unusual chills and pyrexia after a non documented bout of malaria, followed by nausea, then jaundice with dark-red urines despite another treatment with halofantrine. A sepsis was eliminated by two negatives thick peripheral blood drop examinations. Hemolysis was noted with 8.1 g/dl of hemoglobin, Coombs positive, and LDH at 1,452 IU/l, associated to renal failure with 34 ml per minute of clearance. The outcome was favourable with rehydration. Blackwater fever has been described with the three aminoalcohols, but mainly in severe presentations. Clinicians are not familiar with this disease, even though it has major therapeutic implications: quinine, halofantrine, and mefloquine become strictly contra-indicated. Moderate forms may be unknown, and this observation should be taken into account to prevent mistreatment in future patients.
authors.affiliation: Clinique Brévié, hôpital Principal, Dakar, Sénégal. mariebouldouyre@netcourrier.com
authors.forename: M-A
authors.initials: MA
authors.lastname: Bouldouyre
authors.forename: D
authors.initials: D
authors.lastname: Dia
authors.forename: T
authors.initials: T
authors.lastname: Carmoi
authors.forename: K Ba
authors.initials: KB
authors.lastname: Fall
authors.forename: B
authors.initials: B
authors.lastname: Chevalier
authors.forename: J-M
authors.initials: JM
authors.lastname: Debonne
mesh_terms: D058186:Acute Kidney Injury; D000962:Antimalarials / Q000627:therapeutic use*; D001742:Blackwater Fever / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D016701:Guinea; D006461:Hemolysis; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D000962:Antimalarials