AN UNUSUAL MALARIA CASE: MIXED INFECTION? RESISTANCE? MALADAPTIVE PATIENT?

The original article was published on August 31, 2023. https://dergipark.org.tr/en/pub/kutfd/article/1229345

Erratum Note

In the case report entitled “AN UNUSUAL MALARIA CASE: MIXED INFECTION? RESISTANCE? MALADAPTIVE PATIENT?”, published in Volume 25, Issue 2 (2023), the author requested that the sentence “The blood smear showed, banana-shaped gametocytes and young trophozoids compatible with P. falciparum were observed (Figures 1 and 2),” which was inadvertently included as the final sentence of the first paragraph of the “Case Report” section, be corrected to “The blood smear showed parasites appearing as signet rings in erythrocytes, consistent with malaria (Figures 1 and 2).” This correction has been reviewed and approved by our Editorial Board.

Abstract

Malaria, a disease known since ancient times and constantly struggled by human beings, still maintains its currency as an important cause of morbidity and mortality today. Although no domestic cases have been observed in Turkey since 2010, around 200-250 malaria cases originating from abroad are observed every year. Resistance to many parasitic drugs has developed over the years since chloroquine resistance emerged in the 1970s. Artemisinin resistance was reported by WHO in Cambodia, Laos, Myanmar, Thailand and Vietnam in 2013 due to P. falciparum malaria, and resistance has been reported also in South Africa and Rwanda recently. It has been shown that resistance development is due to the Kelch 13 mutation detected in parasite and this leads to delayed clearance. According to WHO data, artemether-based combined therapy is still effective in the treatment of patients infected with artemisinin-resistant P. falciparum strains, but possible treatment unresponsiveness is followed meticulously by WHO. Our case is remarkable for its third recurrence despite artemether-based combined therapy twice in 28 days, and its persistent treatment response after quinine and doxycycline treatment.

Keywords

• Malaria
• kelch 13 mutation
• artemisinin resistance

Project Number

Yok

Alışılmadık bir Sıtma Vakası: Mikst Enfeksiyon mu? Direnç mi? Uyumsuz Hasta mı?

The original article was published on August 31, 2023. https://dergipark.org.tr/en/pub/kutfd/article/1229345

Erratum Note

2023 yılındaki 25. cilt 2. sayıda yayımlanmış olan, "AN UNUSUAL MALARIA CASE: MIXED INFECTION? RESISTANCE? MALADAPTIVE PATIENT?" başlıklı olgu sunumu yazısında, "Case Report" bölümü birinci paragrafı son cümlesindeki sehven yazılan "The blood smear showed, banana-shaped gametocytes and young trophozoids compatible with P.falciparum were observed (Figure 1, 2). " ifadesinin "The blood smear showed, parasites seen as signet ring in erythrocytes compatible with malaria were observed (Figure 1, 2). " şeklinde düzeltilmesi yazar tarafından istenmiş; Editöryel Kurulumuzca düzeltme yapılması uygun bulunmuştur.

Abstract

Antik çağlardan beri bilinen ve insanoğlunun sürekli mücadele ettiği bir hastalık olan sıtma, günümüzde önemli bir morbidite ve mortalite nedeni olarak güncelliğini korumaktadır. Türkiye'de 2010 yılından bu yana yurtiçinde herhangi bir vaka görülmemekle birlikte, her yıl yaklaşık 200-250 civarında yurt dışından kaynaklanan sıtma vakası görülmektedir. 1970'lerde klorokin direncinin ortaya çıkmasından bu yana yıllar içinde birçok paraziter ilaca karşı direnç gelişmiştir. Artemisinin direnci, DSÖ tarafından 2013 yılında P. falciparum sıtmasına bağlı olarak Kamboçya, Laos, Myanmar, Tayland ve Vietnam'da rapor edilmiş olup, son zamanlarda Güney Afrika ve Ruanda'da da direnç bildirilmiştir. Direnç gelişiminin parazitte tespit edilen Kelch 13 mutasyonuna bağlı olduğu ve bu durumun klirensin gecikmesine yol açtığı gösterilmiştir. DSÖ verilerine göre artemisinin dirençli P. falciparum suşları ile enfekte hastaların tedavisinde artemether-bazlı kombine tedavi halen etkilidir ancak olası tedavi yanıtsızlığı DSÖ tarafından titizlikle takip edilmektedir. Olgumuz, 28 günde iki kez artemether bazlı kombine tedaviye rağmen üçüncü nüksü olması, kinin ve doksisiklin tedavisi sonrasında ise kalıcı tedavi yanıtı ile dikkat çekicidir.

Keywords

• Sıtma
• kelch 13 mutasyonu
• artemisin direnci

Supporting Institution

Yok

Project Number

Yok

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