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Systemic Brucellosis with Arrhythmogenic Cardiac Inflammatory Pseudotumor
Krzysztof Kaczmarek1, Romuald Wojnicz2, Paweł Ptaszyński1
1Department of Electrocardiology, Central University Hospital, Medical University of Łódź, Łódź, Poland.
The American Journal of Case Reports
|July 29, 2022
Summary
A rare cardiac inflammatory pseudotumor was diagnosed in a patient with ventricular tachycardia. Successful antibiotic treatment for disseminated brucellosis resolved the cardiac lesions, highlighting the importance of considering infections in arrhythmias.
Area of Science:
- Cardiology
- Infectious Diseases
- Pathology
Background:
- Cardiac inflammatory pseudotumors are rare, with potential links to immunologic issues, infections, or trauma.
- Ventricular tachycardia and sudden death are risks associated with cardiac tumors.
- This report details the diagnosis and treatment of a non-sarcoid multiorgan pseudotumor involving the heart.
Observation:
- A 38-year-old woman presented with symptomatic ventricular tachycardia, with other cardiac causes ruled out.
- Endomyocardial biopsy revealed a cardiac inflammatory pseudotumor.
- Extensive testing led to a diagnosis of disseminated brucellosis with cardiac involvement.
Findings:
- Antibiotic therapy (ceftriaxone, doxycycline, rifampicin) resulted in complete resolution of cardiac lesions.
- A 5-year follow-up confirmed sustained recovery.
- A subcutaneous implantable cardioverter-defibrillator was implanted due to unpredictable ventricular tachycardia risk.
Implications:
- Advanced diagnostics can identify rare cardiac inflammatory pseudotumors.
- Infectious causes, particularly in travelers, should be considered for arrhythmias.
- Cardiac MRI may aid in detecting myocardial lesions in 'idiopathic ventricular tachycardias'.
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