Treatment Failure and Post-Artesunate Delayed Haemolysis in a Returned Traveller From Uganda With Partially Drug-Resistant Severe Plasmodium falciparum Malaria.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 41549418.
- Also identified by DOI 10.5694/mja2.70136 and PMC identifier 12813300.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
A man aged in his 40s, recently returned from Uganda, was hospitalised with Plasmodium falciparum malaria, with hyperparasitaemia of ~1.5 × 10<sup>6</sup> parasites/μL (26%). He received intravenous artesunate followed by artemether-lumefantrine. However, parasite clearance was delayed, and despite a negative blood film following treatment, the patient was readmitted 3 weeks later with recurrent parasitaemia. Further testing for drug-resistant phenotypes and genotypes demonstrated reduced susceptibility to lumefantrine, an A675V mutation in the pfk13 gene and increased ring-stage survival, consistent with partial artemisinin resistance. The case highlights the high risk of P. falciparum treatment failure in patients with hyperparasitaemia and partial drug resistance.
Medical subject headings
- Malaria, Falciparum
- Antimalarials
- Artemisinins