Studies on the etiology of blackwater fever / I.J. Kligler.

  • Israel Jacob Kligler
Date:
1923
Catalogue details

Licence: Public Domain Mark

Credit: Studies on the etiology of blackwater fever / I.J. Kligler. Source: Wellcome Collection.

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    of the cases had tropical malaria (2 with gametes) and in the fourth the benign tertian parasite was found. Two of them possess special interest because the attacks occurred in the . hospital after the injection of relatively small doses of quinine and the development of the condition could be followed from the beginning. A brief description of these two is given below: . §. H., girl, fourteen years. Admitted January 21, 1921. Only ten months in the country. Had repeated attacks of malaria during six months. prior to admission. Quinine treatment irregular. Came to hospital because of fear of blackwater fever. Blood examination showed tropical gametes. On January 22, 1921, quinine injections were started, 0.05 gram, 8.45 a.m.; 0.5 gram, 11 a.m.; 0.5 gram, 6 p.m During . the night the patient had an attack of blackwater fever: temperature 38.3°C., pulse 120; body and sclerae jaundiced; urine red. Examina- tion of urine: hemoglobin-+ ; albumin-+; bile —; red cells —; epithelial cells and casts +. The next day the urine was clear and the tempera- ture returned to normal. Quinine was later given without the de- velopment of hemoglobinuria. The patient is now well. R. L., girl, sixteen years. Admitted March 15, 1921. Repeated attacks of malaria during past year. Quinine treatment irregular. Had two attacks of hemoglobinuria, the last two weeks before entering the hospital. One week after admission to the hospital she received a dose of 0.4 gram of quinine on two successive days and 0.5 gram on the third day. A few hours after the last injection the patient developed hemoglobinuria. ‘Temperature 38.6°C.; pulse 120; body and sclerae jaundiced; urine deep red. Examination of the urine revealed the presence of hemoglobin, albumin, white and epithelial cells and casts. Red cells were rare. No malarial parasites could be found in the blood at this time, but four weeks later, while still in the hospital, the patient had an attack of malaria and parasites of the tertian variety were found. The history and findings of these two cases are typical of the rest. The attack was characterized by a rise in temperature with a corresponding increase in pulse rate and dark red urine containing hemoglobin, albumin, and casts, but practically de- void of red cells. As the urine cleared, the temperature fell and the condition of the patient improved.
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