Volume 29, Number 4—April 2023
Research Letter
Blackwater Fever Treated with Steroids in Nonimmune Patient, Italy
Anna Rita Di Biase, Dora Buonfrate, Francesca Stefanelli, Giorgio Zavarise, Erica Franceschini, Cristina Mussini, Lorenzo Iughetti, and Federico Gobbi
Table
Laboratory exams during hospitalization for a 12-year-old girl with blackwater fever, Modena, Italy*
| Parameter | Day 1 | Day 2 | Day 4 | Day 7 | Day 10 | Day 13 | Day 23 | Follow-up |
|---|---|---|---|---|---|---|---|---|
| Labwork | ||||||||
| Hemoglobin, g/dL | 12.3 | 9.1 | 7.8 | 10.2 | 7.9 | 9.9 | 10.1 | 12.6 |
| Platelets, 103/mmc | 27 | 45 | 96 | 79 | 354 | 379 | 451 | 301 |
| Bilirubin, mg/dL | 1.96 | 1.53 | 1.21 | 1.06 | 1.57 | 2.25 | 0.61 | 0.42 |
| ALT, U/L | 77 | 79 | 389 | 446 | 260 | 124 | 62 | 12 |
| AST, U/L | NA | NA | 1398 | 1435 | 254 | 128 | 35 | NA |
| LDH, U/L | 1870 | 1732 | 7676 | 7200 | 5147 | 5646 | 1715 | 513 |
| PCR, mg/dL | 23.8 | 15.2 | 24.3 | 11.6 | 1.5 | 1.8 | <0.2 | <0.2 |
| Hemoglobinuria |
N |
N |
Y |
Y |
Y |
Y |
N |
N |
| Treatment | ||||||||
| Artesunate | × | × | – | – | – | – | – | – |
| Artemether/lumefantrine | – | – | ׆ | – | – | – | – | – |
| Blood transfusion | – | – | × | – | ׇ | – | – | – |
| Steroids | – | – | – | – | – | ק | – | – |
*ALT, alanine aminotransferase; AST, aspartate aminotransferase; LDH, lactate dehydrogenase; N, no; NA, not applicable; PCR, polymerase chain reaction; Y, yes; ×, administered; –, not administered. †Days 3–5. ‡Days 10, 12 and 16. §Days 13–17.
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