Blackwater Fever
Black water fever is a rare complication that occurs in those who have or have had malaria. Internationally it is known as blackwater fever or BWF. This disease was discovered in 1884 by Easmond.
Black water fever is associated with two factors. One is the recent or recurrent infection caused by Plasmodium falciparum . The other is the intermittent consumption of quinine or one of its derivatives. This disease has a dramatic clinical course and leads to high mortality.
Historically, there was a time when the occurrence of black water fever in tropical areas was significantly reduced. This, mainly, thanks to the use of chloroquine. However, recently the parasite developed resistance to this substance. This caused quinine to be reintroduced. The result was an increase in cases.
Characteristics of black water fever
Malaria is caused by the bite of an Anopheles mosquito that is infected. There are four types of malaria, but the one caused by Plasmodium falciparum is the one that gives rise to black water fever. However, a case was reported in which the disease originated from Plasmodium vivax .
What happens in black water fever is that the red blood cells explode. This process takes place in the bloodstream and is called hemolysis. When this happens, the hemoglobin reaches the blood vessels and urine directly. This often leads to kidney failure.
This disease leads to large amounts of blood being lost. Also a significant volume of albumin, a protein that is present in tissues and body fluids.
This disease also causes hemoglobin to be eliminated in large quantities. This is the protein in red blood cells that carries oxygen in the body.
Like malaria or malaria, black water fever is a tropical disease. One of the main symptoms of it is dark colored urine. That is precisely the characteristic from which it derives its name. This color is due to the breakdown of hemoglobin.
Causes and symptoms
Science does not know why this disease causes hemolytic crises. The most widely accepted hypothesis is that it is an autoimmune reaction. It is possible that this is produced by the interaction of the malaria parasite with the use of quinine.
Black water fever usually comes on suddenly. There is fever, agitated emotional state and prostration. The usual thing is that pain arises in the areas of the bladder and kidneys. Persistent nausea and vomiting also occur. In most cases, the patient’s skin takes on a yellowish hue.
With the passage of time, the urine becomes increasingly darker in color. Also, the frequency of urination begins to decrease
In many cases, urine production disappears completely. In this way, very critical episodes or moments are presented. They have a wide variety of symptoms, many of them dangerous.
The mortality caused by this disease is very high. Typically, a first attack occurs and patients survive. However, they are left with a particular vulnerability to develop a second attack, which is always more serious. If there is a third attack, the chances of survival are slim to none.
Diagnosis and prognosis
The initial diagnosis is made by medical inspection. Black water fever is suspected when hepatomegaly or splenomegaly is present in patients who are or have been in tropical areas. Hepatomegaly is a disproportionate enlargement of the liver.
The diagnosis is confirmed by laboratory tests. Blood smears should be taken, at intervals of 6 to 12 hours. These are examined under the microscope and thus the presence of malaria, originating from Plasmodium falciparum , can be detected .
Black water fever does not have a specific cure. When it comes to very severe cases, they must be treated directly in the hospital. There are preventive treatments for those who live in or travel to a tropical area.
However, its effectiveness is not total. Most of the people who get this disease die. Apparently only a quarter of those who suffer from it survive.
