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Meningitis and high-grade, second-degree atrioventricular block in an adolescent: causal effect or coincidence?

Lee D Murphy1, Amy R Florez1, Richard J Czosek1,2

  • 1The Heart Institute, Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

Cardiology in the Young
|May 10, 2021
PubMed

Insights

This case study highlights an adolescent with Streptococcus pneumoniae meningitis who developed severe atrioventricular block requiring a pacemaker. It emphasizes that infections can cause cardiac rhythm disturbances, not just independent cardiac issues.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Atrioventricular block is a condition affecting the heart's electrical signaling.
  • Meningitis is a serious infection of the membranes surrounding the brain and spinal cord.
  • Infections can sometimes lead to cardiac complications.

Purpose of the Study:

  • To report a rare case of Streptococcus pneumoniae meningitis complicated by high-grade atrioventricular block in an adolescent.
  • To discuss the potential causal relationship between infection and cardiac rhythm disturbances.
  • To raise awareness of non-cardiac etiologies for heart rhythm problems.

Main Methods:

  • Case report of an adolescent patient.
  • Clinical presentation and diagnostic workup.
  • Management including permanent pacemaker implantation.

Main Results:

  • The adolescent patient presented with symptoms of both meningitis and atrioventricular block.
  • High-grade, second-degree atrioventricular block necessitated permanent pacemaker placement.
  • The etiological link between meningitis and atrioventricular block remained uncertain.

Conclusions:

  • Infectious etiologies, such as Streptococcus pneumoniae meningitis, should be considered in the differential diagnosis of atrioventricular block.
  • Cardiac rhythm disturbances may be secondary to systemic infections.
  • Clinicians should maintain a high index of suspicion for cardiac involvement in infectious diseases.
Keywords:
High-grade heart blockStreptococcus pneumoniae meningitispacemakersecond-degree atrioventricular blockseizureshock (circulatory)

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