A Case of Primaquine-Resistant Tertian Malaria

Kim, Ji Hoon; Park, Kyung Soo; Lee, Jong Min; Choi, Ji Hyeon; Lee, In Seok; Kim, Mi Young; Kim, Yang Ree; Kang, Moon Won

Abstract

Plasmodium vivax has many stages in the life cycle, and shows different susceptibilities to anti-malarial drugs at each stage. Of these drugs, primaquine is only drug that has anti-malarial activity to hypnozoite. Generally, primaquine is administered for the prevention of relapse by hypnozoite following the treatment with chloroquine in tertian malaria, at the dosage of 15mg/ day for 14 days. But Plasmodium vivax has different susceptibility to primaquine in different areas (so as to strains), and the resistance to primaquine is increasing in endemic areas. We recently experienced a case of imported tertian malaria that relapsed two times after the completions of chloroquine-primaquine therapy. The patient was treated with 22.5 mg of primaquine for 2 weeks at the first relapse, and 3 weeks course of 30 mg of primaquine in the second relapsing episode. Therefore we report this primaquine-resistant tertian malaria with review.