Genetic confirmation of atovaquone-proguanil-resistant Plasmodium falciparum malaria acquired by a nonimmune traveler to East Africa

Clin Infect Dis. 2003 Aug 1;37(3):450-1. doi: 10.1086/375599. Epub 2003 Jul 18.

Abstract

We report a case of atovaquone-proguanil-resistant Plasmodium falciparum malaria acquired by a nonimmune traveler to Kenya. Recurrent parasitemia occurred 30 days after directly observed therapy with a combination of atovaquone and proguanil. Treatment failure was confirmed by genetic fingerprinting and sequencing. The primary isolate had wild-type sequence of cytochrome b; however, the recrudescent isolate had a single mutation at position 268 (Tyr268Ser).

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Animals
  • Antimalarials / therapeutic use*
  • Atovaquone
  • Cytochrome b Group / genetics
  • Cytochrome b Group / metabolism
  • Drug Resistance / genetics*
  • Drug Therapy, Combination
  • Female
  • Humans
  • Kenya / epidemiology
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / epidemiology
  • Naphthoquinones / therapeutic use*
  • Plasmodium falciparum / drug effects*
  • Plasmodium falciparum / genetics
  • Proguanil / therapeutic use*
  • Travel
  • Treatment Failure

Substances

  • Antimalarials
  • Cytochrome b Group
  • Naphthoquinones
  • Proguanil
  • Atovaquone