Atovaquone-proguanil resistance in imported falciparum malaria in a young child

Pediatr Infect Dis J. 2008 Jun;27(6):567-9. doi: 10.1097/INF.0b013e318167918d.

Abstract

We discuss a case of atovaquone-proguanil treatment failure in a child from Mozambique, recently arrived in North America. Four weeks after completing therapy, symptomatic parasitemia recurred, caused by Plasmodium falciparum parasites bearing a Tyr268Ser mutation in cytochrome b. We review the literature concerning atovaquone-proguanil resistance, and emphasize the importance of follow-up and consideration of resistance where patients have relapsed symptoms.

Publication types

  • Case Reports

MeSH terms

  • Animals
  • Antimalarials / pharmacology*
  • Antimalarials / therapeutic use
  • Atovaquone / pharmacology*
  • Atovaquone / therapeutic use
  • Child
  • Cytochromes c / genetics
  • Drug Combinations
  • Drug Resistance / genetics*
  • Humans
  • Malaria, Falciparum / parasitology*
  • Male
  • Mozambique
  • Mutation, Missense
  • North America
  • Parasitemia
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / isolation & purification
  • Proguanil / pharmacology*
  • Proguanil / therapeutic use
  • Treatment Failure

Substances

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