Blackwater fever in an uncomplicated Plasmodium falciparum patient treated with dihydroartemisinin-piperaquine

Chanthap Lon*, Michele Spring, Somethy Sok, Soklyda Chann, Rathvichet Bun, Mali Ittiverakul, Nillawan Buathong, Khengheng Thay, Nareth Kong, Yom You, Worachet Kuntawunginn, Charlotte A. Lanteri, David L. Saunders

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


The mechanism of massive intravascular haemolysis occurring during the treatment of malaria infection resulting in haemoglobinuria, commonly known as blackwater fever (BWF), remains unknown. BWF is most often seen in those with severe malaria treated with amino-alcohol drugs, including quinine, mefloquine and halofantrine. The potential for drugs containing artemisinins, chloroquine or piperaquine to cause oxidant haemolysis is believed to be much lower, particularly during treatment of uncomplicated malaria. Here is an unusual case of BWF, which developed on day 2 of treatment for uncomplicated Plasmodium falciparum infection with dihydroartemisinin-piperaquine (DHA-PIP) with documented evidence of concomitant seropositivity for Chikungunya infection.

Original languageEnglish
Article number96
Pages (from-to)1-4
Number of pages4
JournalMalaria Journal
Issue number1
StatePublished - 14 Mar 2014
Externally publishedYes


  • Blackwater fever
  • Cambodia
  • Dihydroartemisinin-piperaquine
  • Malaria
  • Plasmodium falciparum


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