Abstract
BACKGROUND: Tick-borne diseases, including Lyme disease, are becoming increasingly common in Europe. Lyme disease has a wide variety of clinical manifestations, as a result of which physicians of diverse disciplines are coming into contact with such patients.
CASE DESCRIPTION: A 58-year-old man was seen at the emergency room with a symptomatic Wenckebach-type second-degree atrioventricular (AV) block and periods of 2:1 AV block. Four weeks previously the patient had noticed a red skin lesion on his left lower leg. Under the working diagnosis of early disseminated Lyme disease with cardiac involvement, treatment with ceftriaxone was started. This diagnosis was supported by a positive Borrelia PCR and culture of a skin biopsy and positive Borreliaserology. The AV conduction disorders resolved completely after 2 weeks of treatment with antibiotics and it was not necessary to implant a pacemaker.
CONCLUSION: A Borrelia infection is a reversible but rare cause of AV conduction disorders. In the event of sudden onset of symptoms or a severe or progressive AV conduction disorder, Lyme carditis should be considered, especially if the medical history or physical examination provides clues for Lyme disease.
Translated title of the contribution | Second-degree atrioventricular block caused by Lyme disease |
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Original language | Dutch |
Article number | D4214 |
Journal | Nederlands Tijdschrift voor Geneeskunde |
Volume | 164 |
Issue number | 7 |
Publication status | Published - 24 Jan 2020 |
Keywords
- Anti-Bacterial Agents/therapeutic use
- Atrioventricular Block/microbiology
- Borrelia burgdorferi
- Ceftriaxone/therapeutic use
- Europe
- Humans
- Lyme Disease/complications
- Male
- Middle Aged
- Pacemaker, Artificial