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Delayed onset haemolysis occurring post-artesunate and post-artemisinin combination therapy is secondary to delayed clearance of infected erythrocytes spared by pitting during treatment. We report a case of severe post-treatment delayed haemolytic anaemia with a positive direct antiglobulin test and a positive response to corticosteroid therapy, suggesting an associated immune mechanism.

Since it is not routine practice in France to raise public awareness about the risk of acquiring multidrug-resistant Enterobacteriaceae (MRE) during international travel, we aimed to determine, among French travellers attending a consultation for travel medicine, their level of knowledge about the risk of acquiring MRE. Among 191 adults enrolled in the study, only 10% of travellers were aware of the risk of becoming a carrier of MRE during travel, and 87% did not understand the difference between being colonized with MRE, and having a clinical infection with MRE. Consultations for travel medicine could be an opportunity to deliver specific information about the risks of acquiring MRE. Antibiotic resistance among Gram-negative bacteria is an emerging problem worldwide, mainly with the diffusion of extended spectrum beta-lactamase, plasmid-encoded cephalosporinases and carbapenemases-producing Enterobacteriaceae. These strains often show multi-resistance and are now diffusing worldwide in the community setting, outside of the hospital. Travel in areas endemic for multidrug-resistant Enterobacteriaceae (MRE) has been identified as a risk factor for the acquisition of MRE.1–5 Faecal colonization with MRE is very frequent among travellers to tropical regions, with a risk ranging from 20 to 70%, especially among those visiting the South Asian continent.2,3,5 Moreover, antibiotic use could favour proliferation of MRE by disrupting the intestinal microbiota balance, and the use of antibiotics for travel diarrhoea was associated with a 4-fold increase in the risk of acquiring MRE, whereas travel diarrhoea itself was only associated with a 2-fold increase in risk.2,3,6 Taken together, these elements suggest that informing the public about the risk of acquiring MRE during international travel could represent a preventive measure against the spread of MRE in France. The French public has been made aware of multidrug-resistant (MDR) bacteria through a media campaign conducted …