In vivo chloroquine resistant P. falciparum in Calcutta. A case report
De, M.K.; Maity, C.R.; Hati, A.K.
Indian Journal of Medical Sciences 45(2): 39-41
1991
ISSN/ISBN: 0019-5359 PMID: 2060980 Document Number: 386941
A 45-year-old man from Calcutta, West Bengal, India, presented with fever, chills and rigors, along with extreme weakness. Blood films revealed Plasmodium falciparum with an asexual parasitaemia of 1800/mmsuperscript 3. Chloroquine treatment appeared to be successful with parasitaemia eliminated after 2 days, but the patient again presented with fever just over a month later. A P. falciparum parasitaemia of 200/mmsuperscript 3 was detected. After further chloroquine treatment parasitaemia disappeared but reappeared again after 21 days. The patient was successfully treated with pyrimethamine and sulfadoxine after which he remained well for 6.5 months. After this time he again presented with similar symptoms and a parasitaemia of 4200/mmsuperscript 3 was detected. He was again treated with chloroquine, which cleared the parasitaemia from the 5th day of treatment. However, parasitaemia reappeared 20 days later, confirming this to be a case of R-1 chloroquine resistance, delayed recrudescence type. The patient was treated with pyrimethamine-sulfadoxine thereafter.