[Successful Treatment of Two Cases of Plasmodium falciparum Malaria that Developed Recrudescence after Artemether-Lumefantrine Therapy].

There are increasing reports of failure of artemisinin-based combination therapy (ACT) in malaria patients returning from endemic areas. ACT has been used globally as first-line treatment for Plasmodium falciparum malaria. However, with the emergence of artemisinin-resistant strains of P.falciparum and their spread across Southeast Asia, there is a risk that these resistant strains could reach areas of high malaria incidence in Africa and elsewhere. In this case report, two cases of malaria imported from Africa, initially treated with six doses of artemether-lumefantrine (AL) were presented. Two middle-aged men returning from Gabon and Uganda developed symptoms of malaria in Türkiye and were hospitalized and diagnosed as P.falciparum malaria. Both patients were treated with AL. After being discharged from the hospital with marked improvement, they re-admitted to the hospital with high fever and chills and showed late signs of clinical failure. One patient was completely cleared of parasites with six doses of AL treatment and the other after non-ACT antimalarial (quinine and doxycycline) treatment and no recrudescence occurred. AL, an artemisinin-based combination, is a frequently preferred preparation for the treatment of malaria cases seen in Türkiye. It should be kept in mind that even if parasitemia is cleared in the peripheral blood smear after three days of appropriate AL treatment, treatment failure may be seen in patients and this treatment failure may also include cases of African P.falciparum malaria.