When Sepsis Mimics a Channelopathy: Brugada Phenocopy in a Patient With Urinary Tract Infection

Brugada phenocopies are clinical entities characterized by electrocardiographic patterns identical to those of congenital Brugada syndrome but occurring in the context of identifiable, reversible underlying conditions. Distinguishing between these two conditions is crucial, as their management and prognostic implications differ substantially. We report the case of a 71-year-old man with no prior cardiovascular history or family history of sudden cardiac death, who was admitted for confusion associated with general deterioration. The admission electrocardiogram (ECG) revealed a type 2 Brugada pattern. Laboratory findings demonstrated a significant inflammatory response, and an infectious workup confirmed a Klebsiella pneumoniae urinary tract infection. Serial ECGs showed complete normalization of the Brugada pattern following antibiotic therapy, consistent with a diagnosis of Brugada phenocopy. This case highlights the importance of considering Brugada phenocopy in patients presenting with Brugada-type ECG changes in the setting of acute infection, thereby avoiding unnecessary invasive interventions such as implantable cardioverter-defibrillator placement.