Remedy or tragedy: Acalypha indica-induced acute oxidative hemolysis associated with acute kidney injury and infective endocarditis: An initial presentation of G6PD Deficiency: A case report

Abstract

Acalypha indica is used as an herbal broth in Sri Lanka for medicinal purposes. It can induce acute oxidative hemolysis and severe methemoglobinemia in G6PD deficiency patients. Leptospirosis is an endemic infection in Sri Lanka, resembling the clinical presentation of acute oxidative hemolysis in G6PD deficiency. As the presentation can mimic leptospirosis, a high index of suspicion is maintained when an infective focus is not identified in patients with fever, jaundice, and hematuria. Here, we present a case of a 33-year-old male patient with hemolysis following Acalypha herbal broth ingestion. He has recovered from acute oxidative hemolysis with supportive management, but he acquired infective endocarditis during inward stay through the central intravenous line, necessitating valve replacement.