Abstract
Intravenous artesunate therapy is the first-line therapy for severe malaria, and is highly efficacious when used in combination with an oral partner drug such as doxycycline or atovaquone-proguanil. However, treatment failure occurs routinely with artesunate monotherapy due to the very short half-life of this drug. In North America, experience with artesunate is limited. With the pressure to discharge patients early, administration of the essential oral partner drug is often left to the discretion of the patient. Thus, treatment failure may be commonplace if nonadherence is a factor, as was observed in the case described in the present report.
Highlights
Intravenous artesunate therapy is the first-line therapy for severe malaria, and is highly efficacious when used in combination with an oral partner drug such as doxycycline or atovaquone-proguanil
Case presentation A case involving a 26-year-old woman from Sudan in the winter of 2011 is presented. During her immigration flight from Sudan via Frankfurt, Germany to Calgary, Alberta, she began to experience fevers and abdominal pain. She presented directly to the emergency room (ER) on day 0, where she was afebrile with normal vital signs
A set of malaria smears drawn that evening identified 2.1% Plasmodium falciparum. Because of her confusion and impaired level of consciousness, the patient was classified as a severe case of malaria [1]
Summary
Intravenous artesunate therapy is the first-line therapy for severe malaria, and is highly efficacious when used in combination with an oral partner drug such as doxycycline or atovaquone-proguanil. L’artésunate par voie intraveineuse, le traitement de première ligne du paludisme sévère, est très efficace lorsqu’on l’utilise en association avec un médicament complémentaire par voie orale, comme la doxycycline ou l’atovaquone-proguanil. She presented directly to the emergency room (ER) on day 0, where she was afebrile with normal vital signs.
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