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Clinical Observations on the Renal Insufficiency in Blackwater Fever

Report of a Case

Elam C. Toone, Jr.Department of Medicine, Medical College of Virginia, Richmond, Virginia

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Recent articles appearing in the literature dealing with renal changes in transfusion reactions and references to similar changes occurring in the kidneys in other conditions producing massive destruction of erythrocytes led us to report this case of blackwater fever with the clinical and laboratory observations of the extensive renal dysfunction.

CASE REPORT An unconscious colored male was admitted to the hospital after an illness of about one week's duration. The only history available was that obtained from a brother who had not been with the patient during the entire period of his present illness. Seven days prior to admission the patient began to complain of a headache and appeared somewhat dazed to members of his family. From this time on his condition grew progressively worse, and two days before entering the hospital he became so drowsy that it was difficult to arouse him. At this time a physician was called who examined a specimen of urine and made a diagnosis of “kidney trouble” with “uremic poisoning.”