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
- Abrupt onset of fever
- marked hemolysis
- hemoglobinuria
- hyperbilirubinemia
- vomiting
- circulatory collapse
- acute renal failure
Treatment
Fluids by mouth and iv glucose if vomiting is present.
High carbohydrate diets if diuresis occurs.
Antimalarial therapy
Antipyretics
Blood transfusion to correct the anemia
Prednisolone to prevent further hemolysis
Treat acute renal failure accordingly.