Hydrocortisone administration improved heart rate within 48 hours in a patient with unexplained sinus bradycardia and presumptive intestinal tuberculosis.
Case Report (n=1)
Does hydrocortisone improve heart rate in a patient with presumptive isolated intestinal tuberculosis and unexplained sinus bradycardia?
This case illustrates a rare temporal association between presumptive intestinal tuberculosis and steroid-responsive bradycardia, highlighting the importance of considering systemic inflammatory processes in unexplained bradycardia.
Intestinal tuberculosis (TB) typically presents with gastrointestinal symptoms, and cardiac conduction abnormalities associated with isolated intestinal TB have rarely been reported. We describe a 37-year-old male presenting with abdominal pain, constipation, and significant weight loss, with epidemiological exposure to cattle and raw milk. During hospitalization, he developed sinus bradycardia with a lowest corrected heart rate of approximately 46 beats per minute. The bradycardia persisted despite treatment with propantheline and atropine. Colonoscopy revealed terminal ileitis, and histopathology demonstrated nonspecific chronic ileitis without granuloma formation. Cardiac evaluation including echocardiography, troponin levels, electrolytes, and serum cortisol was unremarkable. Hydrocortisone administration was temporally associated with improvement in heart rate within 48 hours. Empirical anti-tuberculosis therapy was subsequently initiated, and the patient demonstrated sustained clinical improvement. Although causality cannot be definitively established, this case illustrates a rare temporal association between presumptive intestinal tuberculosis and steroid-responsive bradycardia. The report highlights the importance of considering systemic inflammatory processes in unexplained bradycardia, particularly in tuberculosis-endemic settings.
Islam et al. (Mon,) conducted a case report in Presumptive Isolated Intestinal Tuberculosis (n=1). Hydrocortisone was evaluated on Improvement in heart rate. Hydrocortisone administration improved heart rate within 48 hours in a patient with unexplained sinus bradycardia and presumptive intestinal tuberculosis.