Résumé
Les cas d’échecs thérapeutiques après traitement par des combinaisons thérapeutiques à base d’artémisinine (CTA ou ACT) restent peu courants dans les zones d’endémie palustre. Au Cambodge, en revanche, la défaillance de ces traitements est maintenant couramment observée. Ces cas sont habituellement uniques et une deuxième administration du même traitement est suffisante pour avoir une guérison du patient. Nous présentons ici un cas clinique original d’un patient infecté par Plasmodium falciparum ayant présenté des épisodes successifs de recrudescences parasitaires après traitement par dihydroartémisinine-pipéraquine (Eurartesim ®). Ce cas s’inscrit dans la problématique actuelle de résistance des parasites aux traitements de dernière génération en Asie du Sud-Est et souligne la difficulté à lutter efficacement contre le paludisme dans cette région si de nouvelles lignes thérapeutiques ne sont pas déployées.
Abstract
Cases of treatment failures following administration of artemisinin-based combination therapies (ACT) remain rare in malaria endemic areas. In Cambodia, however, failures of these treatments are now commonly observed. Usually, these post-treatment recurrences occur only once and a second course of the same treatment is sufficient to cure patients.We describe here an atypical case of a Plasmodium falciparum-infected patient manifesting several malaria recrudescence episodes following dihydroartemisinin-piperaquine (Eurartesim®) treatment. This case report illustrates the current issue of resistance to the latest generation of antimalarial drugs in Southeast Asia and highlights the difficulty in efficaciously fighting malaria in this region if new therapy remains unimplemented.
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Witkowski, B., Khim, N., Kim, S. et al. Echecs thérapeutiques multiples et successifs chez un patient infecté par Plasmodium falciparum au Cambodge et traité par dihydroartémisinine-pipéraquine. Bull. Soc. Pathol. Exot. 109, 87–90 (2016). https://doi.org/10.1007/s13149-016-0487-4
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DOI: https://doi.org/10.1007/s13149-016-0487-4
Mots clés
- Plasmodium falciparum
- Paludisme
- Dihydroartémisinine-pipéraquine
- Chimiorésistance
- Kachaun
- Ratanakiri
- Cambodge
- Asie du Sud-Est