Severe unresolving Plasmodium falciparum malaria following artemisinin combination therapy: Emergence of drug resistance in Saudi Arabia

A 5-year-old female child presented with fever of 1-week duration after visiting a malaria endemic zone without antimalarial prophylaxis. The patient presented with respiratory distress, decreased level of consciousness and high-grade fever. An elevated parasitaemia reaching 800,000/μl was observed....

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Bibliographic Details
Published in:Indian journal of medical microbiology 2016-10, Vol.34 (4), p.553-557
Main Authors: Al-Zaydani, IA, Al-Hakami, A, Kumar, A, Abdalla, SA, Otaif, M, Thiqa, RMA, Ahmed, H, Alnahili, K
Format: Article
Language:English
Subjects:
Artesunate
malaria
Plasmodium falciparum
resistance
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Summary:A 5-year-old female child presented with fever of 1-week duration after visiting a malaria endemic zone without antimalarial prophylaxis. The patient presented with respiratory distress, decreased level of consciousness and high-grade fever. An elevated parasitaemia reaching 800,000/μl was observed. Antimalarial therapy was initiated with artesunate being administered intravenous (IV) along with IV clindamycin. Contrary to the expectations, there was no resolution of fever. Following a week of unresolved fever, the drug therapy was revised and altered to IV quinine dihydrochloride and IV clindamycin. Emergence of non-responsiveness to artesunate in Saudi Arabia is an alarming sign and requires revision of management protocols.
ISSN:0255-0857
1998-3646
DOI:10.4103/0255-0857.195352