Recrudescence of a high parasitaemia, severe Plasmodium falciparum malaria episode, treated by artesunate monotherapy

A patient presenting with severe malaria, with hyperparasitaemia, received 7-day artesunate monotherapy. A severe recrudescence was detected and attributed to hyperparasitaemia, monotherapy and a polyclonal infection without Kelch 13 gene mutation. A second treatment with artesunate, then quinine, followed by artemether-lumefantrine, was successful. (c) 2021 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-ncnd/4.0/).

Automated summary

A patient with severe malaria and hyperparasitaemia was initially treated with 7-day artesunate monotherapy, which led to a severe recrudescence due to hyperparasitaemia, monotherapy, and a polyclonal infection without Kelch 13 gene mutation. Subsequent treatments with artesunate, quinine, and artemether-lumefantrine were successful in curing the patient.