title: Severe atovaquone-resistant Plasmodium falciparum malaria in a Canadian traveller returned from the Indian subcontinent.
abstract: We report the first case of atovaquone/proguanil treatment failure in severe Plasmodium falciparum malaria acquired by a non-immune traveller to the Indian subcontinent. Recrudescent infection was complicated by neurological involvement 14 days after directly observed therapy with atovaquone/proguanil. Sequence analysis of the plasmodial cytochrome b gene confirmed a contribution of atovaquone resistance to treatment failure. The recrudescent isolate had a single mutation at position 268 (Tyr268Cys). Video recordings illustrate dramatic but ephemeral manifestations of malaria with neurological involvement.
authors: Thomas L
authors: TL
authors: Perry
authors: Prativa
authors: P
authors: Pandey
authors: Jennifer M
authors: JM
authors: Grant
authors: Kevin C
authors: KC
authors: Kain