1. Relapsing malaria: two cases of malaria presenting 8 months after return from Africa despite adherence to antimalarial chemoprophylaxis
- Author
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Gemma S Morgan, Peter Chiodini, and Mark Evans
- Subjects
myalgia ,Male ,medicine.medical_specialty ,Pediatrics ,Delayed Diagnosis ,Adolescent ,Proguanil ,Plasmodium ovale ,Clinical Intelligence ,Medication Adherence ,Antimalarials ,Chloroquine ,Recurrence ,parasitic diseases ,medicine ,Humans ,Atovaquone ,Doxycycline ,Travel ,Mefloquine ,business.industry ,Malaria prophylaxis ,medicine.disease ,United Kingdom ,Surgery ,Malaria ,Drug Combinations ,Chemoprophylaxis ,Africa ,medicine.symptom ,Family Practice ,business ,human activities ,medicine.drug - Abstract
It has become increasingly common for UK patients to travel to malarial regions: in 2004 over 2.5 million visits were made by UK individuals to countries in which malaria is endemic, representing a 300% increase since 1987.1 Malaria prophylaxis routinely provided in general practice comprises atovaquone–proguanil, mefloquine, doxycycline, or chloroquine plus proguanil. This article describes two cases of malaria that presented 8 months after foreign travel, despite adherence to antimalarial prophylaxis. Two 16-year-old boys presented to the same UK hospital during the same week. Both had a 2-week history of unexplained fever and myalgia. They had travelled together to a malarious area of Kenya for a fortnight 8 months previously on a school trip, and had shared a tent. Both pupils reported adherence to a complete course of atovaquone–proguanil (Malarone®, GSK) on this trip, and had not been to any other malarious regions subsequently. Neither patient reported symptoms at the time of the trip or on initial return to the UK; nor were any other pupils or staff member on the …
- Published
- 2012