Danger of self-administered malaria prophylaxy

Background Mefloquine and pyrimethamine-sulfadoxine combination are recomme nded, as is quinine, for self-administered malaria prophylaxy. Patients sho uld be carefully informed about appropriate use of this therapeutic scheme and advised on the importance of strict compliance to avoid overdose. Case report We report the case of a patient who did not follow the prescrib ed dosage and who developed acute neurological disorders after overdosing. The patient developed seizures attributable to the sulfadoxine-pyrimethamin e combination and mefloquinique encephalopathy. Discussion Sulfadoxine-pyrimethamine-related seizures are exceptional and r esult from an overdose of pyrimethamine. The neurotoxicity of mefloquine is well-known and is particularly frequent at curative dosage. Toxic encephal opathy is a serious neurological manifestation which is slowly reversible d epending on individual predisposition. Antimalaria prophylaxy requires conc erted efforts on the part of the traveler and the prescribing physician. Se lf-ad ministration schemes can be both most useful and dangerous due to exp ected benefits and potential risks.