The management of Brugada syndrome unmasked by fever in a patient with cellulitis
Bibliographic record
Abstract
Brugada syndrome is a rare condition associated with increased risk of ventricular tachyarrhythmias and sudden cardiac death.1 Given its potential consequences, emergency physicians, internists and cardiologists must be familiar with the electrocardiographic features of Brugada syndrome. The typical ECG features are recognised to fluctuate,2 and are known to be revealed by several precipitants including febrile illness.3 ,4 The appearance of a Brugada-type ECG with fever may indicate an elevated risk of arrhythmia or sudden cardiac death. The following case describes the incidental ECG finding of the Brugada pattern in a patient who presented with fever and cellulitis. These findings resolved with treatment of the precipitating medical illness. We report a 74-year-old, white man who presented to the emergency department with a 4-day history of fever associated with lower left leg pain, swelling and erythema. Further review of systems was unremarkable. Specifically, the patient denied any history of chest pain, dyspnoea, palpitations, syncope or presyncope. The patient's history included hypertension, dyslipidaemia and benign prostatic hyperplasia. The patient also endorsed an episode of cellulitis 7 years prior to the current presentation that was treated with oral antibiotics without complications. His medications were rosuvastatin, alfuzosin, a combination of diclofenac and misoprostol, and vitamin D supplements. He did not report any medication allergies. He denied any significant exposure to cigarettes, alcohol or illicit substances. His family history was unremarkable. He did not report any prior history of sudden death in relatives. On examination, the patient did not appear to be in distress. He was febrile (39.6°C) and tachycardic (heart rate 121 bpm). Remaining vital signs were within normal limits. On the lateral aspect of the lower left leg proximal to the ankle, there was a large, non-raised, tender area of erythema with poorly defined borders, consistent with cellulitis. Cardiovascular examination revealed normal …
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".