A Febrile Patient with an Abnormal ECG
Department of Medicine, Baylor College of Medicine
Department of Medicine, Baylor College of Medicine
Abstract
A 60-year-old woman presented to the emergency department with two weeks of progressive malaise, anorexia, and fever. Evaluation revealed leukocytosis, thrombocytopenia, and acute kidney injury. Murine typhus was suspected and confirmed serologically. During a febrile episode, an ECG revealed a notable abnormality. Can you identify it?
Clinical Vignette
A 60-year-old woman presented to the emergency department with two weeks of progressive malaise, anorexia, and fever. Evaluation revealed leukocytosis, thrombocytopenia, and acute kidney injury. Murine typhus was suspected due to exposure to multiple animals and an absence of an alternative infectious syndrome. She received doxycycline empirically, and improved rapidly. Serologic results subsequently confirmed the diagnosis with a Rickettsia typhi IgM of >1:1024. During a febrile and tachycardic episode in the hospital, the patient's ECG showed the following (Figure 1):
What abnormality is present in this ECG?
References (1)
- 1. Brugada J, Campuzano O, Arbelo E, Sarquella-Brugada G, Brugada R. Present Status of Brugada Syndrome: JACC State-of-the-Art Review. J Am Coll Cardiol. 2018;72(9):1046-1059. doi:10.1016/j.jacc.2018.06.037