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Case Reports in Medicine
Volume 2017, Article ID 4297372, 3 pages
https://doi.org/10.1155/2017/4297372
Case Report

An Unexpected Cause of Bradycardia in a Patient with Bacterial Meningitis

Department of Internal Medicine, University Hospital of Heraklion, Crete, Greece

Correspondence should be addressed to Petros Ioannou; moc.liamtoh@oi_sortep

Received 27 April 2017; Accepted 29 May 2017; Published 21 June 2017

Academic Editor: Bruno Megarbane

Copyright © 2017 Petros Ioannou et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Sinus bradycardia which is a sinus rhythm with a resting heart rate of less than 60 bpm is caused by intrinsic cardiac disorders like sick sinus syndrome or inferior myocardial infarction, metabolic and environmental causes (such as hypothyroidism and electrolyte disorders), medications (such as beta-blockers and amiodarone), infection (such as myocarditis), increased intracranial pressure, and toxic exposure, while it can sometimes be a normal phenomenon, especially during sleep, in athletes, and during pregnancy. Symptomatic sinus bradycardia should warrant a thorough work-up in order to identify any reversible causes; otherwise, placement of a permanent pacemaker could be needed. We present the case of a patient who was admitted due to confusion and fever and was found to have pneumococcal meningitis and bacteremia, and during his hospital stay he developed symptomatic sinus bradycardia that was of intractable cause and persistent. Placement of a permanent pacemaker was chosen until the night staff of the hospital discovered by chance the neglected cause of his bradycardia.