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It is a common impression, particularly in this section of the country, that blackwater fever (massive hemoglobinuria) is caused only by malarial infections. It is known, however, that occasionally blackwater fever is caused by toxemia from drugs or by severe infections. Lesser grades of hemoglobinuria are common, especially since the use of the various sulfanilamide preparations has become universal. The term hemoglobinuria is used to designate the excretion of the blood pigment in the urine with the absence of red blood cells or with an insufficient number to account for the alteration of the urine. Blackwater fever is the term applied when the amount of this pigment is massive; this large quantity is sufficient to render the urine very dark or black in appearance.
Other causes of hemoglobinuria are organic and inorganic poisons such as quinine, phenol, glycerin and blood from incompatible donors, and severe toxemias due to burns and
Gotten HB, MacGowan JJ. BLACKWATER FEVER (HEMOGLOBINURIA) CAUSE BY SPIDER BITE. JAMA. 1940;114(16):1547. doi:10.1001/jama.1940.62810160004010b
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