Black water fever

By | 15th May 2012

It s the most severe complication of chronic malaria caused by plasmodium falciparum. It is seen commonly in those who have taken the antimalrial treatment irregularly or are G6PD deficient.


It is called so due to production of black, dark brown urine owing to intravascular hemolysis


Clinical features


  1. Abrupt onset of fever
  2. marked hemolysis
  3. hemoglobinuria
  4. hyperbilirubinemia
  5. vomiting
  6. circulatory collapse
  7. acute renal failure





Fluids by mouth and iv glucose if vomiting is present.

High carbohydrate diets if diuresis occurs.


Antimalarial therapy


Blood transfusion to correct the anemia

Prednisolone to prevent further hemolysis

Treat acute renal failure accordingly.