DIETMAR GANN, M.D.; ONKAR S. NARULA, M.D.; SHERMAN KAPLAN, M.D.; PHILIP SAMET, M.D.
An 18-year-old white girl presented to the emergency room with a chief complaint of lightheadedness and syncope. An electrocardiogram showed complete heart block, atrial rate of 120/min, ventricular rate of 32/min with a pattern of complete right bundle branch block, and +95° axis. One week before admission she noticed macules on her left hand that developed into papules and hemorrhagic vesicles. She then noticed a mild pharyngitis. Fever, chills, arthralgias, and arthritis were all absent.
At physical examination her blood pressure was 120/80 mm Hg, pulse 32 and regular, and temperature 36.6°C. The pharynx appeared normal, and lungs were clear
GANN D, NARULA OS, KAPLAN S, SAMET P. Complete Heart Block with Gonococcal Septicemia. Ann Intern Med. ;86:749–750. doi: 10.7326/0003-4819-86-6-749
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Published: Ann Intern Med. 1977;86(6):749-750.
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