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- KUMAGAI Yukio
- The First Department of Internal Medicine, Kyushu University School of Medicine
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- KUSHIMOTO Koichi
- The First Department of Internal Medicine, Kyushu University School of Medicine
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- SAWAE Yoshiro
- The First Department of Internal Medicine, Kyushu University School of Medicine
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- AOKI Tomonobu
- Infectious Disease Center, Fukuoka Municipal Hospital
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- MORIYASU Masafumi
- Infectious Disease Center, Fukuoka Municipal Hospital
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- GOYA Nagahide
- Infectious Disease Center, Fukuoka Municipal Hospital
Bibliographic Information
- Other Title
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- キニーネおよびMP錠の治療により黒水熱に陥った熱帯熱マラリアの1例
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Description
A 34-year-old male became ill after returning to Japan from Guinea, where he already had contracted malarial fever. He was admitted to the Infectious Disease Center, FukuokaMunicipal Hospital, complaining of fever, jaundice and general fatigue. An examination of peripheral blood smear showed severe malarial parasitaemia with P. falciparum. The parasitic count was calculated as greater than 240, 000/mm3. He was orally given only 500 mg of quinine and 4 tablets of MP-tablet (sulfamonomethoxine250 mg & pyrimethamine 12.5 mg). After several hours he became confused andpassed dark urine. The next morning the parasitic count had decreased to 6, 300/m3, but he lost consciousness and showed hemoglobinuria, severe jaundice and slight renal dysfunction. Acute intravascular hemolysis was suggested by the marked decrease in hemoglobin, increase in serum lactate dehydrogenase, hyperbilirubinemia and hemoglobinuria. He was administered quinine intravenously because of frequent vomiting. The following day he regained consciousness, and passed clear urine, and the parasites had disappeared from the peripheral blood. There have been many reports of acute intravascular hemolysis following the use of quinine to treat Falciparum Malaria. Based on the time relationship between the use of quinine and the acute manifestation, it was strongly suggested that the use ofquinine was the cause of this Black Water fever. However, the continuous injection of quinine fortunately brought about cure without progressive hemolysis.
Journal
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- Kansenshogaku Zasshi
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Kansenshogaku Zasshi 60 (7), 707-710, 1986
The Japanese Association for Infectious Diseases
