title: Lyme disease: a case report of a 17-year-old male with fatal Lyme carditis.
abstract: Lyme disease is a systemic infection commonly found in the northeastern, mid-Atlantic, and north-central regions of the United States. Of the many systemic manifestations of Lyme disease, cardiac involvement is uncommon and rarely causes mortality. We describe a case of a 17-year-old adolescent who died unexpectedly after a 3-week viral-like syndrome. Postmortem examination was remarkable for diffuse pancarditis characterized by extensive infiltrates of lymphocytes and focal interstitial fibrosis. In the cardiac tissue, Borrelia burgdorferi was identified via special stains, immunohistochemistry, and polymerase chain reaction. The findings support B. burgdorferi as the causative agent for his fulminant carditis and that the patient suffered fatal Lyme carditis. Usually, Lyme carditis is associated with conduction disturbances and is a treatable condition. Nevertheless, few cases of mortality have been reported in the literature. Here, we report a rare example of fatal Lyme carditis in an unsuspected patient.
authors: Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA. Electronic address: yoone@wcmc.com.
authors: Esther C
authors: EC
authors: Yoon
authors: Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
authors: Eric
authors: E
authors: Vail
authors: Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
authors: George
authors: G
authors: Kleinman
authors: Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
authors: Patrick A
authors: PA
authors: Lento
authors: Department of Pediatrics, New York Medical College, Maria Fareri Children's Hospital, Valhalla, NY, USA.
authors: Simon
authors: S
authors: Li
authors: Department of Microbiology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
authors: Guiqing
authors: G
authors: Wang
authors: Wadsworth Center, New York State Department of Health, Albany, NY, USA.
authors: Ronald
authors: R
authors: Limberger
authors: Department of Pathology, Westchester Medical Center and New York Medical College, Valhalla, NY, USA.
authors: John T
authors: JT
authors: Fallon
mesh_terms: D000293:Adolescent; D017809:Fatal Outcome; D006801:Humans; D008193:Lyme Disease / Q000150:complications*; D008297:Male; D009205:Myocarditis / Q000469:parasitology* / Q000473:pathology / Q000503:physiopathology
keywords: Arrhythmia; Borrelia burgdorferi; Carditis; Heart block; Lyme carditis; Lyme disease; Myocarditis; Pediatric; Spirochetes; Ventricular tachycardia