Pulmonary toxicity with mefloquine

This report presents a case of acute lung injury developing within hours af ter administration of mefloquine for a low-level Plasmodium falciparum mala ria, which was persistent despite halofantrine therapy. Extensive microbiol ogical investigation remained negative and video-assisted thoracoscopic lun g biopsy demonstrated diffuse alveolar damage. The evolution was favourable without treatment. This is the second report of acute lung injury and diffuse alveolar damage caused by mefloquine. Glucose-6-phosphate dehydrogenase deficiency was pres ent in the former case and was thought to contribute to the lung injury. Ho wever, glucose-phosphate dehydrogenase was normal in the present case, sugg esting that it is not a predisposing condition to the lung injury.