E-ISSN 2146-3077
Case Report
The Management of Therapeutic Failure in a Falciparum Malaria Patient under Oral Arthemether-Lumefantrine Therapy
1 Gülhane Askeri Tıp Akademisi Haydarpaşa Eğitim Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Servisi, İstanbul, Türkiye  
2 Gülhane Askeri Tıp Akademisi Haydarpaşa Eğitim Hastanesi, Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Servisi, İstanbul, Türkiye  
Turkiye Parazitol Derg 2014; 38: 61-67
DOI: 10.5152/tpd.2014.3169
Key Words: P. falciparum, recrudescence, recurrence, reinfection, arthemether based therapy
Abstract

Malaria is a parasitic infection characterized by anemia, splenomegaly and periodic fever. This infection has a tendency to cause serious complications. Falciparum malaria could occur in our country as an imported case due to increasing intercontinental travel opportunities. The World Health Organisation (WHO) recommends arthemether combination treatment as a first line choice. Here we report a Turkish case admitted to the hospital with high fever, sweating and fatigue. He had been in Uganda for 6 months without prophylaxis. Plasmodium falciparum with an intense parasitic load was diagnosed. We started arthemether-lumefantrine combination therapy immediately. 18 days after his discharge he was readmitted with the same complaints and parasitemia was detected once again. This time, we treated him with the quinine-tetracycline combination regime for 7 days. Within 48 hours the patient was afebrile and the blood smear was negative. Falciparum malaria must be considered in infection emergencies for febrile patients especially with any travel history. For an initial therapy, arthemether-lumefantrine combination is a successful choice of treatment. Even with adequate treatment of arthemether-lumefantrine combination, the problems of recurrence (recrudescence or reinfection) could occur due to treatment failure. For the possibility of recurrence, close monitoring of patients is very important in the critical course after adequate treatment.

Key Words
Authors
All
Reviewer's Corner
Survey
AVES | Copyright © 2018 Turkish Parasitology Association | Latest Update: 07.06.2018