Severe atovaquone-resistant Plasmodium falciparum malaria in a Canadian traveller returned from the Indian subcontinent.

Abstract

BACKGROUND:

We report the first case of atovaquone/proguanil treatment failure in severe Plasmodium falciparum malaria acquired by a non-immune traveller to the Indian subcontinent. Recrudescent infection was complicated by neurological involvement 14 days after directly observed therapy with atovaquone/proguanil. Sequence analysis of the plasmodial cytochrome b gene confirmed a contribution of atovaquone resistance to treatment failure. The recrudescent isolate had a single mutation at position 268 (Tyr268Cys). Video recordings illustrate dramatic but ephemeral manifestations of malaria with neurological involvement.

• Authors: Thomas L Perry, Prativa Pandey, Jennifer M Grant, Kevin C Kain
• Journal: Open medicine : a peer-reviewed, independent, open-access journal (Open Med) Vol. 3 Issue 1 Pg. e10-6 (Jan 20 2009) ISSN: 1911-2092 [Electronic] Canada
• PMID: 19946387 (Publication Type: Journal Article)