Brugada-like syndrome presenting with monomorphic ventricular tachycardia and Brugada-type electrocardiogram unmasked by fever in an infant: a case report

Abstract

Brugada syndrome is an autosomal-dominant arythmogenic genetic disorder associated with mutation in the SCN5A gene. We report a case of 3-month-old Tanzanian male who was admitted at Muhimbili National Hospital in Dar es Salaam, Tanzania with severe pneumonia, high fever and monomorphic ventricular tachycardia. The patient was treated with intravenous Amiodarone. In addition, oxygen, parenteral antibiotics, antipyretics and intravenous fluids were also given. About 2 hours and 20 minute later the child stabilized. An ECG obtained shortly after termination of ventricular tachycardia showed the typical J-point and coved ST elevation typical of Brugada type I pattern. To the best of our knowledge, this is the first paediatric case with Brugada-type ECG to be reported in Sub-Saharan Africa. This case emphasizes the need to increase awareness among clinicians of clinical and genetic arythmogenic disorders. Multiple ECGs during and after febrile disorders should be performed in children who exhibit extreme tachycardia or signs of cardiac failure.