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It is also important to make sure the child does not have to take any antibiotics at home. In this case report of a 64 year old white woman with ava a history of systemic lupus erythematosus (sle) who developed cardiac disease within 6 weeks after starting hydroxychloroquine, the diagnosis was made post mortem. It is a macrocyclic lactone that interferes with the anthelmintic protein merozoite and inhibits its growth, reproduction, and development.