A 34-year-old woman returns to the UK from Ghana 11 days ago. She presents with fever, headache, and myalgia. She took atovaquone/proguanil prophylaxi...

Question

A 34-year-old woman returns to the UK from Ghana 11 days ago. She presents with fever, headache, and myalgia. She took atovaquone/proguanil prophylaxis with perfect adherence, completing the full 7-day post-travel course. A thick blood film shows P. ovale trophozoites. How can this be explained despite correct atovaquone/proguanil prophylaxis?

Accepted Answer

Atovaquone/proguanil has causal prophylactic activity against P. falciparum liver stages but hypnozoites of P. ovale may not be fully eliminated, allowing delayed relapse

Answer

Atovaquone/proguanil resistance in P. ovale

Answer

The patient must have been non-adherent

Answer

Atovaquone/proguanil has no activity against any Plasmodium species

Answer

P. ovale cannot be acquired in Ghana

uk-dtmh MCQ (SBA): Breakthrough P. ovale Despite Prophylaxis