Editor—The homoeopathic principle that like should be cured with like is not always advisable,1 as illustrated in this case report.
A 40 year old woman took two holidays a year in tropical countries. After experiencing digestive disorders with conventional prophylactic drugs she decided to seek medical advice from a homoeopath for her forthcoming holiday in Togo. Two homeopathic drugs were prescribed: Ledum palustre 5 CH (Boiron, Sainte-Foy-lès-Lyon, France) as one granule daily and Malaria officinalis 4 CH (Schmidt-Nagel, Meyrin, Switzerland) as a single dose on the day before departure.
Ledum palustre 5 CH can be purchased in any French pharmacy and is usually taken to prevent insect bites or to reduce allergic reactions and pruritus. Malaria officinalis 4 CH is unavailable in France and therefore was bought by mail order. The preparation is taken “against malaria” as the doctor or patient sees fit. It is made from “African swamp water containing impurities, algae and plants as well as mosquito slough, larvae and eggs.” Furthermore, “the manufacturer, who has performed no clinical trials on this drug, declines all responsibility regarding its use.” No instructions are supplied, and the destination of the journey and duration of the stay are not taken into account.
Five days after returning to France with a fever (39°C), the patient sought medical advice from her homoeopath. Results of a blood smear test for malaria parasites were negative; haemoglobin concentration was 13.9 g/l and platelet count 160000 per mm3. She took homoeopathic drugs with vitamins, and a few days later antibiotic treatment was started. Ten days after the first medical visit she felt worse. Her temperature had risen to 41°C and her haemoglobin concentration was 10.6 g/l and platelet count 66000 per mm3. She was admitted to hospital, where she was investigated for bacterial infection but not malaria. Four days later she was admitted with neurological disorders to the intensive care unit at this hospital. An emergency search for malaria showed the presence of Plasmodium falciparum (parasitaemia 7%). For two months she received intensive care for multiple organ system failure due to P falciparum.
This case confirms the inefficacy of homoeopathic drugs for malaria prevention and treatment.2 Travellers to tropical countries should use recognised prophylactic drugs.