Preprint Case Report Version 1 Preserved in Portico This version is not peer-reviewed

Prophylaxis Failure and Successful Management of Delayed-onset Malaria with Renal Complications: A Case Report with Oral Artemether-Lumefantrine Treatment

Version 1 : Received: 21 September 2023 / Approved: 21 September 2023 / Online: 22 September 2023 (02:58:59 CEST)

A peer-reviewed article of this Preprint also exists.

Tolaj, I.; Bunjaku, G.; Mehmeti, M.; Begolli, Y. Prophylaxis Failure and Successful Management of Delayed-Onset Malaria with Renal Complications: A Case Report with Oral Artemether-Lumefantrine Treatment. Reports 2023, 6, 53. Tolaj, I.; Bunjaku, G.; Mehmeti, M.; Begolli, Y. Prophylaxis Failure and Successful Management of Delayed-Onset Malaria with Renal Complications: A Case Report with Oral Artemether-Lumefantrine Treatment. Reports 2023, 6, 53.

Abstract

This case report presents a critical clinical scenario involving a 55-year-old patient who developed severe Plasmodium falciparum malaria with renal complications despite receiving doxycycline prophylaxis while travelling in a malaria-endemic region. The case emphasizes the potential failure of doxycycline prophylaxis and highlights the importance of considering malaria in patients with a history of travel to endemic areas, even if they have adhered to prophylactic treatment. The patient's clinical presentation included fever, extreme fatigue, and loss of consciousness, leading to hospitalization. Laboratory findings revealed severe anaemia, elevated liver enzymes, and impaired renal function, consistent with the criteria for severe malaria. The diagnosis was confirmed by the presence of Plasmodium falciparum parasites on blood smears. Due to limited access to parenteral antimalarial medications, the patient received oral artemether-lumefantrine, resulting in clinical improvement. Supportive care and dialysis played a vital role in the patient's recovery. This case report underscores the need for increased awareness of prophylaxis failure, the challenges of managing severe malaria in non-endemic countries, and the importance of timely and appropriate interventions to improve outcomes in severe malaria cases, particularly those with renal involvement. Further research is warranted to evaluate alternative preventive strategies in regions with drug-resistant malaria strains.

Keywords

severe malaria; Plasmodium falciparum; chemoprophylaxis failure; oral artemether-lumefantrine

Subject

Medicine and Pharmacology, Epidemiology and Infectious Diseases

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