Persistent atrioventricular block in Lyme borreliosis

Klin Wochenschr. 1990 Apr 17;68(8):431-5. doi: 10.1007/BF01648587.

Abstract

Cardiac manifestations are reported in 0.3%-4.0% of European patients with Borrelia burgdorferi (B.b.) infection. Usually symptoms disappear within 6 weeks. We report a case with persistent impairment of atrioventricular (AV) conduction. Diagnosis was confirmed by demonstration of IgM antibodies and increase of IgG antibody titers against B.b. in serum, by isolation of the spirochete from skin biopsy material and by the typical clinical combination of erythema migrans, Bannwarth syndrome (meningoradiculitis), and complete heart block. Despite immediate antibiotic therapy with ceftriaxone, first degree AV block and second degree block Wenckebach with atrial pacing at 100 beats/minute persisted for 2 years. We conclude, that Lyme carditis can cause long-standing or irreversible AV conduction defects despite adequate and early antimicrobial therapy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Ceftriaxone / therapeutic use
  • Chronic Disease
  • Diagnosis, Differential
  • Erythema Chronicum Migrans / complications
  • Erythema Chronicum Migrans / diagnosis
  • Erythema Chronicum Migrans / drug therapy
  • Female
  • Heart Block / diagnosis
  • Heart Block / drug therapy
  • Heart Block / etiology*
  • Humans
  • Lyme Disease / complications*
  • Lyme Disease / diagnosis
  • Lyme Disease / drug therapy

Substances

  • Ceftriaxone