A case of pregnancy complicated by blackwater fever and Bacillus coli pyelitis

Abstract

A case of pregnancy complicated by blackwater fever and B. coli pyelitis is described. Full records of periodic haemoglobin estimations, blood counts, urine analyses, and blood urea estimations are given, from which may be seen the severity of the haemolyses, the consequent changes in the blood picture, the effects of blood transfusions and the progress of the B. coli infection. The results of a renal efficiency test are recorded. Attention is drawn to the apparent rarity of the occurrence of blackwater fever in pregnant women; and it is suggested as an explanation of this that there may be, in the blood of pregnant women, an increase of haemolytic bodies of sufficient amount to prevent the development of blackwater fever. The drip-transfusion of 207 ozs. of blood, including 20 ozs. from the abdomen of a case of ruptured ectopic gestation, is described. As far as we are aware, this is the first record of blood from such an unusual source having been used in a case of blackwater fever, or, indeed, for any condition apart from the auto-transfusion of the original owner. Several attacks of precordial pain are described, with the result of an electrocardiogram. The occurrence of three attacks of erythema with oedema are recorded. The treatment of the malarial infection with atebrin, and of the B. coli infection with mandelic acid and proseptacine, are given. The occurrence of a Staphylococcus aureus furunculosis is described, together with the treatment adopted.