Atrio-ventricular block as the first presentation of disseminated Lyme disease.
A 36 year old male patient presented to emergency cardiology department because of fatigability. ECG revealed high grade II atrio-ventricular block and bradycardia of 31 beats/min. An erythema increasing in size to up to 7-8 cm in diameter appeared a month earlier and spontaneously resolved within 10 days. ELISA testing for antibodies against Borrelia burgdorferi IgM was positive and IgG titer was 1:40. Intravenous ceftriaxone 2g qod, and 0.5 g metronidazole tid lead to regression of grade II block to grade I block within 2 days. Grade I block persisted for an additional 10 days. This is a relatively rare case of early occurrence of Lyme carditis within one month of exposure as the first sign of Lyme disease dissemination.
Gordana
G
Panic
Vid
V
Stanulovic
Tanja
T
Popov
D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology; D003937:Diagnosis, Differential; D006327:Heart Block / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male