title: Hint of Lyme, an uncommon cause of syncope.
abstract: A 20-year-old Caucasian male patient presented after a single episode of syncope. His heart rate was 40 beats per minute. ECG showed new onset complete heart block. A temporary pacer was placed. He had a macular rash on the body from past 2 weeks and was diagnosed with contact dermatitis. Erythema migrans was considered as differential for rash. Lyme titre was ordered and found to be positive. After antibiotic therapy and observation on telemetry, his heart block resolved. He was subsequently discharged and a follow-up ECG revealed persistent normal sinus rhythm.
authors.affiliation: Department of Family Medicine, Guthrie/Robert Packer Hospital, Sayre, Pennsylvania, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Manek
authors.forename: Abhishek
authors.initials: A
authors.lastname: Kulkarni
authors.forename: Anthony
authors.initials: A
authors.lastname: Viera
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001919:Bradycardia / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D002443:Ceftriaxone / Q000627:therapeutic use; D004562:Electrocardiography; D015787:Erythema Chronicum Migrans; D006327:Heart Block / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008193:Lyme Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D009205:Myocarditis / Q000175:diagnosis* / Q000209:etiology; D010138:Pacemaker, Artificial; D013575:Syncope / Q000175:diagnosis* / Q000209:etiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone