Quinine-resistant severe falciparum malaria effectively treated with atovaquone and proguanil hydrochloride combination therapy.
A 22-year-old Japanese man noticed pyrexia and diarrhea after travel to Guinea. Notable physical findings included hepatosplenomegaly. Treatment with oral quinine and minocycline was started after definitive diagnosis of falciparum malaria by blood smear. Initially, parasitemia and body temperature decreased but by the third night of therapy his temperature increased to 40 degrees C with a slight increase of parasite count. When quinine treatment was changed to atovaquone/proguanil, his temperature dropped immediately and complete plasmodial elimination was confirmed on microscopic examination. Subsequent recrudescence of the disease was not observed. It was concluded that the antimalarial treatment with atovaquone/proguanil might become invaluable in Japan.
Uchiyama
Hitoji
H
Department of Medicine, Nantan General Hospital, Funai-gun, Kyoto.
Okamoto
Akio
A
Sato
Katsuaki
K
Yamada
Tomohiro
T
Murakami
Sadatsugu
S
Yoneda
Seiichi
S
Kajita
Yoshihiro
Y
Tegoshi
Tatsuya
T
Arizono
Naoki
N
D000328:Adult; D053626:Atovaquone; D001774:Blood Chemical Analysis; D001854:Bone Marrow Cells / Q000166:cytology / Q000469:parasitology; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy*; D008297:Male; D009285:Naphthoquinones / Q000008:administration & dosage*; D002727:Proguanil / Q000008:administration & dosage*; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D009285:Naphthoquinones; D002727:Proguanil; D053626:Atovaquone