Signorini L, Matteelli A, Castelnuovo F, Castelli F, Oladeji O, Carosi G
Clinic of Infectious and Tropical Diseases, University of Brescia, Italy.
Am J Trop Med Hyg. 1996 Nov;55(5):472-3. doi: 10.4269/ajtmh.1996.55.472.
Plasmodium vivax infections caused by strains with low sensitivity to primaquine are widespread in the Western Pacific and Southeast Asia, and have been recently reported from Central America as well. We report a case of primaquine failure in a P. vivax infection acquired in Guatemala. A 28-year-old Italian woman developed two months after returning from Guatemala a vivax malaria attack that was treated with a standard chloroquine course (1,500 mg over three days) combined with primaquine (15 mg/day for 14 days). Two months later, she had a relapse that was again treated with chloroquine and primaquine at the same doses. After two more months, a second relapse occurred: this time primaquine (30 mg/day for 14 days was administered; the patient remained well during a follow-up period of six months and all parasitologic examination results were negative. Doses of primaquine as high as 6 mg/kg total dose may be indicated in the treatment of vivax malaria cases from Central America.
对伯氨喹敏感性较低的间日疟原虫菌株引起的感染在西太平洋和东南亚地区广泛存在，最近中美洲也有相关报道。我们报告了一例在危地马拉感染间日疟原虫后出现伯氨喹治疗失败的病例。一名28岁的意大利女性从危地马拉回国两个月后发生间日疟发作，接受了标准氯喹疗程（三天内共1500毫克）联合伯氨喹（15毫克/天，共14天）治疗。两个月后，她复发，再次接受相同剂量的氯喹和伯氨喹治疗。又过了两个月，出现了第二次复发：这次给予伯氨喹（30毫克/天，共14天）；患者在六个月的随访期内情况良好，所有寄生虫学检查结果均为阴性。治疗来自中美洲的间日疟病例时，可能需要高达6毫克/千克总剂量的伯氨喹。
