title: Blackwater fever in an uncomplicated Plasmodium falciparum patient treated with dihydroartemisinin-piperaquine.
abstract: The mechanism of massive intravascular haemolysis occurring during the treatment of malaria infection resulting in haemoglobinuria, commonly known as blackwater fever (BWF), remains unknown. BWF is most often seen in those with severe malaria treated with amino-alcohol drugs, including quinine, mefloquine and halofantrine. The potential for drugs containing artemisinins, chloroquine or piperaquine to cause oxidant haemolysis is believed to be much lower, particularly during treatment of uncomplicated malaria. Here is an unusual case of BWF, which developed on day 2 of treatment for uncomplicated Plasmodium falciparum infection with dihydroartemisinin-piperaquine (DHA-PIP) with documented evidence of concomitant seropositivity for Chikungunya infection.
authors.affiliation: Armed Forces Research Institute of Medical Sciences (USAMC-AFRIMS), Phnom Penh, Cambodia. ChanthapL@afrims.org.
authors.forename: Chanthap
authors.initials: C
authors.lastname: Lon
authors.forename: Michele
authors.initials: M
authors.lastname: Spring
authors.forename: Somethy
authors.initials: S
authors.lastname: Sok
authors.forename: Soklyda
authors.initials: S
authors.lastname: Chann
authors.forename: Rathvichet
authors.initials: R
authors.lastname: Bun
authors.forename: Mali
authors.initials: M
authors.lastname: Ittiverakul
authors.forename: Nillawan
authors.initials: N
authors.lastname: Buathong
authors.forename: Khengheng
authors.initials: K
authors.lastname: Thay
authors.forename: Nareth
authors.initials: N
authors.lastname: Kong
authors.forename: Yom
authors.initials: Y
authors.lastname: You
authors.forename: Worachet
authors.initials: W
authors.lastname: Kuntawunginn
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Lanteri
authors.forename: David L
authors.initials: DL
authors.lastname: Saunders
mesh_terms: D000328:Adult; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D037621:Artemisinins / Q000627:therapeutic use*; D001742:Blackwater Fever / Q000139:chemically induced* / Q000175:diagnosis* / Q000473:pathology; D004338:Drug Combinations; D006801:Humans; D008297:Male; D011804:Quinolines / Q000009:adverse effects / Q000627:therapeutic use*; D010879:Piperazines
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; D011804:Quinolines; C039060:artenimol; C034759:piperaquine; D010879:Piperazines