Black urine like Coca-Cola
A strange disease that produces "black urine" (urina preta) has re-emerged in the state of Amazonas in the middle of the Amazon River and the state of Bahia in the northeastern part of the river. The site reports. Rhabdomyolysis (rabdomiolise in Portuguese), which develops 12 to 24 hours after eating poisonous fish, is called "black urine" . It is said that black urine like Coca-Cola comes out. The first case in Amazonas was confirmed on August 21st. On the 26th, there were 16 patients suspected of having "black urine" in Itacoatiara, Amazonas, 13 of whom were reportedly hospitalized. Rhabdomyolysis is a disease in which toxins contained in freshwater fish and shellfish cause necrosis and thawing of skeletal muscle cells called striated muscle, which causes severe muscle pain, numbness, and swelling. When myoglobin and protein in muscle cells flow into the blood due to thawing, weakness and reddish brown urine (myoglobin urine) occur, and when myoglobin occludes renal tubules and causes acute renal failure , anuria and oliguria occur. , Edema also occurs. Hypovolemia breathing difficulties and shock symptoms, difficulty walking, chest tightness, paralysis, invited well as convulsions, hyperkalemiaIf this happens, cardiac arrest can also occur. Haff disease, which appears in reports related to the disease, is a rhabdomyolysis syndrome named after the place where it first occurred, and is caused by a heat-resistant toxin possessed by freshwater fish and the like. However, the causative toxin has not yet been identified. Case reports of Huff's disease in the state of Amazonas were uninterrupted, and on August 22, a patient with the disease was confirmed in Manaus, 176 km away from Itacoatiara. In the case, a 51-year-old mother died. The Canaltech site dated August 31 confirmed 44 patients in Amazonas and 6 patients in Bahia as of August 30, and reported that one of them died, but the G1 site on August 1 was in Amazonas. The number of patients was 52 in 8 cities. Of the patients in Amazonas, 36 live in Itacoatiara and the rest have been identified in Silves, Borba, Manaus, Parintins, Kaapiranga, Mawes and Outazes. Freshwater fish that can cause rhabdomyolysis include Pacu, Arapaima, and Tambaqui, which are familiar to the general public. In Itacoatiara, fish sales have already declined in Feira and other areas, but the Amazonas Disease Prevention Foundation (FVS) has advised residents to refrain from eating fish for at least 15 days a day. On the same day, the Amazonas government announced that it would send an expert to Itacoatiara City by forming a countermeasure team. This is the third epidemic of the disease in the state of Amazonas after 2008 and 2015, but this is the first time it has died. On the other hand, cases in Bahia occurred in Alagoinhas, Marau, Salvador, Simones Filho, and Matta de San Giorje. The place of occurrence and the number of patients may be increasing. "The cause is still under investigation," said a health official in the state. In February, two sisters were reported to have the same disease in Recife, Pernambuco, in the northeastern part of the country.
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