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Malaria Journal
Published in: Malaria Journal 1/2018

Open Access 01-12-2018 | Case report

A case of blackwater fever with persistent Plasmodium falciparum parasitaemia detected by PCR after artemether–lumefantrine treatment

Published in: Malaria Journal | Issue 1/2018

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Abstract

Background

Blackwater fever is a complication of malaria infection consisting of a syndrome of febrile intra-vascular haemolysis with severe anaemia and intermittent passage of dark-red to black colour urine. Despite numerous reports and studies of this condition, its pathogenesis remains incompletely understood.

Case presentation

This report describes a case of classic blackwater fever in a returning traveller, without prior history of malaria infection nor usage of anti-malarial prophylaxis, treated with two courses of oral artemether–lumefantrine combination therapy. Unusual persistence of submicroscopic Plasmodium falciparum parasitaemia was detected by PCR for 18 days after initiation of treatment.

Conclusion

To the authors’ knowledge this is the first reported occurrence of a case of blackwater fever associated with prolonged submicroscopic parasitaemia. This unusual case challenges the current knowledge of the pathogenesis of this condition and opens questions that may have important diagnostic and treatment implications.

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Metadata
Title
A case of blackwater fever with persistent Plasmodium falciparum parasitaemia detected by PCR after artemether–lumefantrine treatment
Publication date
01-12-2018
Published in
Malaria Journal / Issue 1/2018
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-018-2180-1

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