Atovaquone-proguanil resistance in imported falciparum malaria in a young child

Abstract

We discuss a case of atovaquone-proguanil treatment failure in a child from Mozambique, recently arrived in North America. Four weeks after completing therapy, symptomatic parasitemia recurred, caused by Plasmodium falciparum parasites bearing a Tyr268Ser mutation in cytochrome b. We review the literature concerning atovaquone-proguanil resistance, and emphasize the importance of follow-up and consideration of resistance where patients have relapsed symptoms.