A Report of Four Cases of Blackwater Fever after Quinine Treatment at Zinder National Hospital, Niger Republic

• Main Authors: Doutchi Mahamadou, Diongolé M. Hassane, Moussa Tondi Maiga Zeinabou, Iliassou Aboubacar, Ali Osseini, Adamou Harissou, Garba Abdoul-Aziz, Alkassoum Ibrahim, Ibrahim Maman Laminou, Adéhossi Eric
• Format: Article
• Language: English
• Published: Hindawi Limited 2019-01-01
• Series: Case Reports in Infectious Diseases
• Online Access: http://dx.doi.org/10.1155/2019/2346087
• ISSN: 2090-6625; 2090-6633

Background. Blackwater fever (BWF) is a rare but serious complication of malaria that is a consequence of antimalarial treatment. Its prevalence seems to have increased. Its diagnosis is based on clinical symptoms and urine color. We report on 4 BWF cases admitted to the infectious diseases department of Zinder National Hospital. Results. Four patients were hospitalized in September 2017 for a hepatorenal syndrome of jaundice, port wine-colored urine, renal failure, and hepatic cytolysis following antimalarial treatment with quinine salts. Quinine treatment was stopped and treatment was continued with injectable artemether. Three patients underwent extra-renal purification. Their evolution was favorable. One patient died less than 24 hours after admission. Conclusion. A rare and severe complication, blackwater fever must be considered for patients under antimalarial treatment who present with jaundice, abdominal pain, and acute renal insufficiency with port wine-colored urine. Rapid diagnosis and management in an intensive care unit are crucial for improving the prognosis.