The Brugada syndrome is characterized by a peculiar ST-segment elevation in the right precordial leads and the propensity to develop ventricular arrhythmias. Mutations in a cardiac sodium channel gene have been linked to this syndrome and some experimental data suggest that the dysfunction of the mutated channel can be temperature sensitive. This report describes a patient in whom a typical Brugada ECG pattern developed in relation to fever but could not be reproduced at normal temperature on administration offlecainide. This case suggests that in some patients a Brugada-like ECG may only manifest during a febrile state.