Blackwater fever

Blackwater fever is a complication of

The most probable explanation for blackwater fever is an autoimmune reaction apparently caused by the interaction of the malaria parasite and the use of quinine. Blackwater fever is caused by heavy parasitization of red blood cells with Plasmodium falciparum. However, there have been other cases attributed to Plasmodium vivax,^[1] Plasmodium malariae,^[2] Plasmodium knowlesi.^[3]

Blackwater fever is a serious complication of malaria, but

Diagnosis

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Blackwater fever should be suspected in a malaria patient who is intermittently passing dark-red to black urine, and is diagnosed using a urine dipstick test, which will be positive for hemoglobin. Microscopy of urine will be negative for erythrocytes.[7]

Treatment

The treatment is

• Brigadier General Charles Young (United States Army officer) first contracted malignant malaria, also known as blackwater fever, in 1913 during a military expedition in Liberia. Given his vulnerability to the disease, he and his family understood that military orders dispatching him back to Liberia in 1921 were akin to suicide, but he refused to retire from the U.S. Army or try to alter his military orders. He contracted the disease again during a visit to Nigeria and died in 1922. The U.S. Army posthumously promoted Young to Brigadier General in 2021.^[8][9][10]
• Prior to his photography career, Henri Cartier-Bresson^[11] contracted blackwater fever while hunting in Western Africa. Expecting to die, he sent instructions to his family on his wishes for a funeral. He made a full recovery.
• Zoologist John Samuel Budgett died from the disease in 1904, after returning from a collecting trip to West Africa, in search of specimens of the fish Polypterus.^[12]
• Missionary and explorer George Grenfell died after a bad attack of blackwater fever at Basoko on 1 July 1906.^{[citation needed]}
• Jesse Brand, a missionary to the Chat Mountains in India, died of blackwater fever in 1928.^{[citation needed]}
• Actor Don Adams, best known as Maxwell Smart from the popular sitcom Get Smart and as the title character in Inspector Gadget, contracted blackwater fever at Guadalcanal during World War II. Adams was evacuated from his United States Marine Corps unit to a hospital in New Zealand where he ultimately made a full recovery.^[13]
• Humanitarian and MMA fighter
  Congo Pygmies in 2013. The affliction nearly claimed Wren's life. He was misdiagnosed four times and required airlift to Uganda, where he narrowly recovered from severe symptoms.^[14]
• Aeneas, Jeannie Gunn's husband, is described as having died from Blackwater Fever or Malarial Dysentry at Elsey Station in the Northern Territory in 1903.^{[citation needed]} She later authored the classic account We of the Never Never.
• Bernard Deacon
• Peter Cameron Scott, a Scottish-American missionary and founder of Africa Inland Mission, died from the disease in December 1896.
• Henry Stricker, South African cricketer

Cultural references

• Isak Dinesen
• The Power of One, a 1992 film based on the book of the same name
• The Bridge on the River Kwai, a 1957 film about prisoners of war in a jungle environment
• At Play in the Fields of the Lord, a 1965 novel by Peter Matthiessen
• West with the Night (1942), African memoir by aviator Beryl Markham
• Burmese Days, a 1934 novel by George Orwell; several associates of Flory are noted to have died of blackwater fever in chapter 5
• Showdown, a 1946 novel by Errol Flynn
• The Heart of the Matter, a 1948 novel by Graham Greene
• Green Hills of Africa, a 1935 novel by Ernest Hemingway
• The Book of Secrets, a 1994 novel by M. G. Vassanji
• The Blackwater Fever, a blues band out of Australia
• An Ice-Cream War, a 1982 novel by William Boyd set during the First World War in German East Africa
• Liberia as I Know It, a 1929 memoir by medical missionary Clinton Caldwell Boone
• Showa period in Japanese history Shigeru Mizuki
• John Brunner quotes a line from the sea chanty "The Bight of Benin": "The bight of Benin, the bight of Benin! Blackwater fever and pounds of quinine!"^[15]
• Blackwater: A True Epic of the Sea, a 1958 memoir of a ship's crew stricken with blackwater fever, by H.L. Tredree
• The Mottled Lizard, a 1962 memoir of Kenya by Elspeth Huxley
• Wolfenstein: The Old Blood, referenced by Wesley (Agent One) near the beginning of the game