What is called blackwater fever?

Blackwater fever, also known as malarial nephrosis or malarial hemoglobinuria, is a severe complication associated with malaria infection. It is characterized by the passage of dark red or black urine, which occurs due to the hemolysis (destruction) of red blood cells. This condition is particularly associated with infection by the malaria parasite Plasmodium falciparum, although it can also rarely occur with other species of malaria parasites.

The dark urine in blackwater fever results from the release of hemoglobin into the bloodstream, which is then filtered by the kidneys and excreted in the urine. This release of hemoglobin occurs when red blood cells are destroyed, often in response to certain medications used in the treatment of malaria, such as quinine or related drugs.

Blackwater fever is a medical emergency and can lead to severe complications, including acute kidney injury and even death if not promptly treated. Management typically involves supportive care, including intravenous fluids to maintain kidney function and medications to manage symptoms and complications.