# When the farm turns fatal: a rare infection causing heart block

## TL;DR

An elderly woman with a rare heart block caused by brucellosis was successfully treated with antibiotics and a pacemaker.

## Contribution

This paper presents a unique case linking brucellosis to complete heart block and emphasizes the need for early diagnosis and treatment.

## Key findings

- Brucella bacteremia was identified as the cause of complete heart block in an 84-year-old woman.
- Treatment with antibiotics and pacemaker implantation led to stabilization of the patient's heart rhythm.
- The case underscores the importance of considering brucellosis in patients with heart block and a history of travel to endemic regions.

## Abstract

Brucellosis, a zoonotic infection typically presenting with nonspecific symptoms, rarely leads to cardiac complications, particularly conduction abnormalities. We report a unique case of an 84-year-old female who presented with dizziness, bradycardia, and hypotension, ultimately diagnosed with complete heart block. On admission, blood cultures and further diagnostic workup identified Brucella bacteremia as the underlying cause, with further history revealing that she had recently traveled from a farm in Colombia, a brucellosis-endemic area. The patient underwent dual-chamber pacemaker implantation to stabilize her heart rhythm and was initiated on a three-month antibiotic regimen of doxycycline and rifampin. This case highlights the importance of considering brucellosis as a differential diagnosis for heart block in patients with recent travel from endemic regions. Early recognition and intervention, including antibiotic therapy and pacemaker placement when necessary, are essential for achieving favorable outcomes in brucellosis-related cardiac complications.