title: Persistent atrioventricular block in Lyme borreliosis.
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.
authors.affiliation: Krankenhaus München-Schwabing, Akademisches Lehrkrankenhaus, Ludwig-Maximilians-Universität München.
authors.forename: W
authors.initials: W
authors.lastname: Mayer
authors.forename: F X
authors.initials: FX
authors.lastname: Kleber
authors.forename: B
authors.initials: B
authors.lastname: Wilske
authors.forename: V
authors.initials: V
authors.lastname: Preac-Mursic
authors.forename: W
authors.initials: W
authors.lastname: Maciejewski
authors.forename: H
authors.initials: H
authors.lastname: Sigl
authors.forename: E
authors.initials: E
authors.lastname: Holzer
authors.forename: W
authors.initials: W
authors.lastname: Doering
mesh_terms: D000328:Adult; D002443:Ceftriaxone / Q000627:therapeutic use; D002908:Chronic Disease; D003937:Diagnosis, Differential; D015787:Erythema Chronicum Migrans / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D008193:Lyme Disease / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D002443:Ceftriaxone