Case Report: The First Case of Genotypically Confirmed K13 Propeller Mutation in Sri Lanka and Its Implications on the Elimination Status of Malaria.

Case Report: The First Case of Genotypically Confirmed K13 Propeller Mutation in Sri Lanka and Its Implications on the Elimination Status of Malaria. Am J Trop Med Hyg. 2020 Dec 14;: Authors: Fernando D, Weerasekera CJ, Gunasekera WMKTAW, Hapuarachchi HC, Koo C, Munas M, Ranaweera P Abstract This case report discusses recrudescence of imported Plasmodium falciparum malaria, in the presence of Kelch13 (K13) propeller mutation, in a patient diagnosed and fully treated with artemether-lumefantrine under direct observation in Sri Lanka. This patient presented with a history of 5 days of fever following his arrival from the Democratic Republic of Congo (DRC). He had visited Rwanda 1 week before arrival to Sri Lanka. Treatment was commenced with artemisinin-based combination therapy, artemether-lumefantrine, which is the first-line drug recommended for uncomplicated falciparum malaria. Blood smears were negative for parasites by the third day of treatment. Approximately 2 weeks later, he developed fever again and was diagnosed as having a recrudescence of falciparum malaria. He was treated and responded to the second-line antimalarial dihydroartemisinin-piperaquine. Molecular testing of blood taken from the first infection revealed the presence of amino acid substitutions K189T and R561H within the PfKelch13 gene. R561H mutation is associated with delayed parasite clearance in Southeast Asia. Although seldom reported from DRC, an emergence...
Source: The American Journal of Tropical Medicine and Hygiene - Category: Tropical Medicine Authors: Tags: Am J Trop Med Hyg Source Type: research