Pyrexia-Induced Brugada Syndrome Unmasked by Community-Acquired Pneumonia: A Case Report

Brugada syndrome is a genetic arrhythmic disorder marked by electrocardiographic abnormalities and a heightened risk of sudden cardiac death, commonly unmasked by various clinical triggers. Although drug exposure and electrolyte disturbances are well-recognized precipitants, fever is an important but underappreciated factor capable of revealing a latent Brugada pattern and provoking malignant ventricular arrhythmias. We present the case of a previously healthy 34-year-old man who developed sustained ventricular tachycardia (VT) following the onset of fever secondary to community-acquired pneumonia. His initial presentation included high-grade fever, productive cough, and pleuritic chest pain. Electrocardiography revealed a type 1 Brugada pattern coinciding with his febrile state, along with frequent ventricular ectopy. The patient subsequently experienced an episode of sustained VT, which required acute stabilization. Following recovery, he underwent placement of an implantable cardioverter-defibrillator for secondary prevention of sudden cardiac death. The case underscores the potential for fever to serve as a trigger for Brugada syndrome and highlights the importance of recognizing this association in febrile patients presenting with suggestive electrocardiographic changes. Prompt identification and management, including aggressive fever control and appropriate implementation of device therapy, are critical for preventing life-threatening outcomes in individuals predisposed to Brugada syndrome. This report aims to raise awareness among clinicians about pyrexia-induced unmasking of Brugada syndrome and emphasizes the necessity for vigilant monitoring in similar high-risk situations.