title: Falciparum Malaria Incidentally Pretreated with Azithromycin.
abstract: A 65-year-old man, who recently returned from Liberia, visited a clinic complaining of fever, and azithromycin was prescribed. The patient presented to a general hospital 5 days after the onset of symptoms, however, a blood smear examination failed to detect malaria. Contrary to the blood smear result, a rapid antigen test in our hospital was strongly-positive for falciparum malaria, indicating a high level of malarial antigen in the blood. Moreover, laboratory examinations on admission showed a tendency for improvement. We assumed that the administration of azithromycin partially treated malaria, thus complicating the blood smear diagnosis. We should be careful in prescribing azithromycin, which is widely used in clinics, to travelers returning from malaria-endemic countries.
authors.affiliation: Department of Infectious Diseases, Respiratory and Digestive Medicine, Faculty of Medicine, University of the Ryukyus, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Shibahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kinjo
authors.forename: Naoya
authors.initials: N
authors.lastname: Nishiyama
authors.forename: Wakaki
authors.initials: W
authors.lastname: Kami
authors.forename: Daijiro
authors.initials: D
authors.lastname: Nabeya
authors.forename: Shusaku
authors.initials: S
authors.lastname: Haranaga
authors.forename: Futoshi
authors.initials: F
authors.lastname: Higa
authors.forename: Masao
authors.initials: M
authors.lastname: Tateyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Shinzato
authors.forename: Hiromu
authors.initials: H
authors.lastname: Toma
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kishimoto
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujita
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D000962:Antimalarials / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage*; D057210:Delayed Diagnosis; D005334:Fever / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D016778:Malaria, Falciparum / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D008297:Male; D010818:Practice Patterns, Physicians'; D014195:Travel
chemical_list: D000900:Anti-Bacterial Agents; D000962:Antimalarials; D017963:Azithromycin