Abstract
The patient was a 62-year-old man who had been previously hospitalized eight times for cellulitis associated with varicose veins of the legs. He was admitted with the same diagnosis on this occasion. Soon after admission, he suddenly lost consciousness in the presence of a nurse, but regained consciousness soon thereafter. However, ventricular fibrillation occurred six times during the following hour or so. He was admitted to the ICU, where ventricular fibrillation did not occur following sedative administration and tracheal intubation, and the tube was removed on the second day of hospitalization. His body temperature on admission to the ICU was 41°C, and characteristic coved-type ST-segment elevation was observed in leads V1 and V2. Although the ST-segment elevation subsequently improved, the patient was diagnosed as having Brugada syndrome, and an implantable cardioverter defibrillator was inserted at a later date. No Brugada-type findings were present on electrocardiogram (ECG) under normal conditions, and although mild ST-segment elevation had been present on a previous ECG when the patient had a fever, it was considered impossible to have diagnosed Brugada syndrome. There have been sporadic reports of Brugada syndrome diagnosed during fever, and this condition should be borne in mind by ICU physicians who have frequent opportunities to examine febrile patients.
