Plasmodium vivax malaria in spite of atovaquone/proguanil (malarone) prophylaxis

J Travel Med. 2003 Nov-Dec;10(6):353-5. doi: 10.2310/7060.2003.9318.

Abstract

A 70-year-old male scientist, who had returned 5 weeks earlier from Ethiopia, was admitted to the hospital with symptoms consistent with malaria. On physical examination, he had orthostatic hypotension. He was dehydrated and showed a mild clinical delirium. Abdominal examination revealed a possible spleen tip, and he had petechial lesions bilaterally below his knees. Laboratory data revealed his white blood cell count to be 4,500/mL, with 67% polymorphonuclear cells and 15% band forms. The hemoglobin level was 13.9 g/dL, and the platelet count was low, at 32,000/mL.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Animals
  • Antimalarials / therapeutic use*
  • Atovaquone
  • Cytochromes b / genetics
  • Drug Administration Schedule
  • Drug Combinations
  • Ethiopia
  • Humans
  • Malaria, Vivax / blood
  • Malaria, Vivax / diagnosis
  • Malaria, Vivax / drug therapy*
  • Malaria, Vivax / prevention & control*
  • Male
  • Naphthoquinones / therapeutic use*
  • Plasmodium vivax / genetics
  • Polymorphism, Genetic
  • Proguanil / therapeutic use*
  • Sequence Analysis, DNA / methods
  • Travel*
  • Treatment Failure
  • United States

Substances

  • Antimalarials
  • Drug Combinations
  • Naphthoquinones
  • atovaquone, proguanil drug combination
  • Cytochromes b
  • Proguanil
  • Atovaquone