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

Abstract EN

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.