P2255 Abstract (poster session) Prophylaxis decision-making following Plasmodium falciparum malaria needlestick injury: a case report F.S. Erdinc, S. Yarimoglu, E. Aktepe, G. Tuncer Ertem*, N. Tulek (Ankara, TR) Objectives: Although Turkey is a malaria endemic country, it is non-endemic for falciparum malaria; falciparum malaria is reported only in patients with travel histories. The transmission risk of the pathogen by occupational exposure to blood is reported higher than human immunodeficiency virus or hepatitis C virus. The case presented here, is the first reported postexposure prophylaxis case for falciparum malaria after occupational needlestick injury. Case: A 25-year-old resident doctor had an occupational needlestick injury while taking a blood sample from a falciparum malaria patient. The needlestick pierced the doctors’ glove and caused a bleeding injury on the finger. The 42-year-old male falciparum malaria patient had a history of visit to Sudan. He had fever (38.6°C), tachycardia (113 beats/min), and icteric skin. His peripheral blood smear was positive for P. falciparum with 40% parasitemia. Artemether and lumefantrine (80 mg/480 mg), 2 tablets, four times a day treatment was started to the patient. On the second day of his treatment, while he was afebrile, the needlestick exposure occurred in the night time. Although the source patient was taking therapy, he had still a parasite load around 25%. Type of the injury was deep and caused bleeding. Transmission risk of the disease was taken into account, and on the following day, artemether and lumefantrine provided by Ankara Public Health Directorate and she took the drugs as used in therapy. She did not experience any side effect and did not have any malaria symptom thereafter. Conclusion: A review of the literature reveals more than 20 cases of occupational falciparum malaria reports including one lethal case. The transmission risk in needlestick injury depends on parasitemia level, inoculum size, and host immune mechanisms. As the treatment is available and well tolerated, and infection if it develops, could be severe and life threatening, decisions about instituting therapy should be individualized..