Genetic confirmation of atovaquone-proguanil-resistant Plasmodium falciparum malaria acquired by a nonimmune traveler to East Africa.

Abstract

We report a case of atovaquone-proguanil-resistant Plasmodium falciparum malaria acquired by a nonimmune traveler to Kenya. Recurrent parasitemia occurred 30 days after directly observed therapy with a combination of atovaquone and proguanil. Treatment failure was confirmed by genetic fingerprinting and sequencing. The primary isolate had wild-type sequence of cytochrome b; however, the recrudescent isolate had a single mutation at position 268 (Tyr268Ser).

• Authors: Eli Schwartz, Shay Bujanover, Kevin C Kain
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 37 Issue 3 Pg. 450-1 (Aug 01 2003) ISSN: 1537-6591 [Electronic] United States
• PMID: 12884171 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antimalarials
• Cytochrome b Group
• Naphthoquinones
• Proguanil
• Atovaquone

Topics

• Adult
• Animals
• Antimalarials (therapeutic use)
• Atovaquone
• Cytochrome b Group (genetics, metabolism)
• Drug Resistance (genetics)
• Drug Therapy, Combination
• Female
• Humans
• Kenya (epidemiology)
• Malaria, Falciparum (drug therapy, epidemiology)
• Naphthoquinones (therapeutic use)
• Plasmodium falciparum (drug effects, genetics)
• Proguanil (therapeutic use)
• Travel
• Treatment Failure