First case report of inducible heart block in Lyme disease and an update of Lyme carditis

Ocular manifestations of Lyme disease (LD) remain a rare feature of the disease, but it may present a wide range of clinical presentations with different combinations. LD related optic neuritis or cranial nerve (CN) six palsy have been reported in the literature. However, this is the first case report of simultaneous involvement of CN 2 and CN 6 in a patient with LD. The diagnosis of LD can be challenging and initial laboratory tests can be a false negative. It is paramount important to repeat the diagnostic test if clinical suspicious is ongoing. With this case, we aim to increase awareness of clinicians for possible ocular manifestations of LD and its complex diagnostic process.

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Temporary Pacing in Complete Heart Block due to Lyme Disease: A Case Report

Pacing and Clinical Electrophysiology ◽

10.1111/j.1540-8159.1989.tb05059.x ◽

1989 ◽

Vol 12 (8) ◽

pp. 1433-1436 ◽

Cited By ~ 12

Author(s):

ISTVAN LORINCZ ◽

ANDRAS LAKOS ◽

PETER KOVACS ◽

CSABA VARVOLGYI ◽

PETER POLGAR ◽

...

Keyword(s):

Case Report ◽

Lyme Disease ◽

Heart Block ◽

Complete Heart Block ◽

Temporary Pacing

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Lyme Borreliosis as Cause of Myocarditis: A Case Report and a Review of the Literature

RA Journal Of Applied Research ◽

10.47191/rajar/v7i12.16 ◽

2021 ◽

Vol 07 (12) ◽

Author(s):

Yousra Serroukh ◽

Keyword(s):

Case Report ◽

Lyme Disease ◽

Lyme Borreliosis ◽

Clinical Manifestations ◽

Left Ventricular ◽

Review Of The Literature ◽

Conduction Disorders ◽

Lyme Carditis ◽

The Subject ◽

Cardiac Manifestation

lyme borreliosis (LB) is the most common tick-born disease in the Northern Hemisphere. During early disseminated Lyme disease, cardiac manifestation can occur. including acute conduction disorders, atrioventricular block, acute myopericarditis or left ventricular dysfunction and rarely cardiomegaly or fatal pericarditis. We report a case of a patient with isolated Lyme myocarditis manifested by acute heart failure with atrial fibrillation and review of the literature on the subject. The interested of this case report is to show the need to acquire the reflex to think about a lyme carditis when patients in endemic areas come to attention with cardiovasculair symtoms, even in the absence of others concurerenr clinical manifestations of early lyme disease.

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A 34-Year-Old Woman with Third-Degree Heart Block and Atrial Flutter Associated with Lyme Carditis: A Case Report

American Journal of Case Reports ◽

10.12659/ajcr.933789 ◽

2021 ◽

Vol 22 ◽

Author(s):

Vishal Khetpal ◽

Tyler W. Wark ◽

Rebecca Masel ◽

Cao Thach Tran ◽

Philip Haines

Keyword(s):

Case Report ◽

Atrial Flutter ◽

Heart Block ◽

Lyme Carditis ◽

Degree Heart Block

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Lyme Carditis in Hospitalized Children and Adults, a Case Series

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab140 ◽

2021 ◽

Author(s):

Richard V Shen ◽

Carol A McCarthy ◽

Robert P Smith

Keyword(s):

Lyme Disease ◽

Heart Block ◽

Early Recognition ◽

Erythema Migrans ◽

Case Series ◽

Outpatient Setting ◽

Temporary Pacing ◽

Lyme Carditis ◽

Viral Illness ◽

History Presentation

Abstract Background Lyme carditis is an uncommon manifestation of Lyme disease. This report compares Lyme carditis presentation, management, and outcomes in pediatric and adult populations. Methods Charts of pediatric and adult patients with heart block (PR >300ms) and positive Lyme serologies hospitalized in Portland, Maine between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described. Results Ten children and 20 adults were admitted for Lyme carditis between June and October. Ninety percent were male, and 87% had no prior cardiac history. Seventeen had outpatient evaluation prior to admission. Of these, a minority (41%) had Lyme disease suspected in the outpatient setting, and fewer (12%) were initiated on Lyme disease treatment. The most common alternate diagnoses were viral illness and erythema multiforme. More children than adults had disseminated erythema migrans and fever. First-degree heart block was more prevalent in children, and Mobitz type 2 heart block was more prevalent in adults. Ten patients presented with syncope. Proportionately more adults needed temporary pacing. Children had shorter antibiotic durations compared to adults. Of the 30 cases, twenty-seven had improved heart block, while 3 adults required a pacemaker at discharge. Nine children and 14 adults were discharged with a PR 200-300ms. There was a single death in this series. Conclusion Cases tended to be younger males. Most patients had some heart block on discharge. Of patients evaluated as outpatients, Lyme disease was suspected in 41%. Improved early recognition and treatment of Lyme disease may decrease Lyme carditis.

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134. A Comparison of Lyme Carditis in Children and Adults, a Case Series

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.209 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S95-S95

Author(s):

Richard V Shen ◽

Carol A McCarthy ◽

Robert P Smith

Keyword(s):

Lyme Disease ◽

Heart Block ◽

Erythema Migrans ◽

Case Series ◽

Adult Patients ◽

Male Predominance ◽

Temporary Pacing ◽

Lyme Carditis ◽

Viral Illness ◽

History Presentation

Abstract Background Lyme disease is a common entity in Maine, and Lyme carditis is an uncommon manifestation of this disease. This case series describes and compares the presentation, management, and outcomes of Lyme carditis in pediatric and adult populations. Methods Charts of pediatric and adult patients with heart block and positive Lyme serologies hospitalized in Portland, Maine between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described. Results Ten children (range 7–17, mean 12.4 years) and 20 adults (range 22–81, mean 41.4 years) were admitted for Lyme carditis in the examined period. All cases presented between June and October. Twenty-seven (90%) were male, and 26 (87%) had no prior cardiac history. Of the adults, 1 (5%) reported using cocaine, 4 (20%) opioids, and 6 (30%) marijuana. Seventeen (57%) had outpatient evaluation prior to admission. Ten patients (59%) were not recognized as having Lyme disease. One case suspected to have Lyme was not initially treated with doxycycline. The most common alternative diagnoses were a viral illness and erythema multiforme. No coinfections were noted. Proportionately more children than adults had disseminated erythema migrans (40% vs. 20%) and fever (60% vs. 35%). First degree heart block was more prevalent in children (40%), and Mobitz type 2 heart block was more prevalent in adults (55%). Ten patients (30%) presented with syncope. More adults than children needed temporary pacing, 9 (45%) vs. 2 (20%). Children had shorter antibiotic durations compared with adults (mean 19.8 days vs. 23.6 days) Twenty-seven (90%) had improved heart block. Three adult patients (10%) required a pacemaker following hospitalization. Nine (90%) children and 14 (70%) adults were discharged with a PR 200-300ms. There was a single death in this series, which occurred after discharge to another state. Conclusion Cases tended to be in younger patients with male predominance. Most patients still had some degree of heart block on discharge. The majority of patients were evaluated prior to hospitalization but Lyme disease was suspected in only 41%. Improved recognition of early Lyme disease and more prompt treatment may lead to decreased complications of Lyme carditis. Disclosures All authors: No reported disclosures.

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Lyme disease like syndrome associated lymphocytoma: first case report in Brazil

Clinics ◽

10.1590/s1807-59322007000400020 ◽

2007 ◽

Vol 62 (4) ◽

pp. 525-526 ◽

Cited By ~ 4

Author(s):

Natalino Yoshinari ◽

Mariana Spolidorio ◽

Virginia Lucia Bonoldi ◽

Miriam Sotto

Keyword(s):

Case Report ◽

Lyme Disease ◽

First Case

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Pacing in a Woman with Full Term Pregnancy: First Case Report in Bangladesh

Cardiovascular Journal ◽

10.3329/cardio.v1i2.8179 ◽

1970 ◽

Vol 1 (2) ◽

pp. 237-239

Author(s):

AW Chowdhury ◽

MA Muttalib ◽

AEM Masharul Islam ◽

AK Choudhury ◽

M Faruk ◽

...

Keyword(s):

Case Report ◽

Heart Block ◽

Complete Heart Block ◽

College Hospital ◽

Medical College ◽

First Case ◽

Congenital Complete Heart Block ◽

Temporary Pacemaker ◽

History Of ◽

Pace Maker

A 19-year-old primigravida was diagnosed to have complete heart block (CHB) during her antenatal checkup at 36 weeks. The patient had history of syncope a few years back. She was referred to the National Institute of Cardiovascular Diseases (NICVD). A temporary pacemaker was implanted at NICVD. She was then referred to Dhaka Medical College Hospital (DMCH), where a baby girl was delivered by cesarean section. A permanent pacemaker was implanted later at NICVD. To our knowledge this is the first case report of pace maker implantation in a pregnant woman from Bangladesh. Key Words: Congenital complete heart block; Pregnancy; Pacemaker. DOI: http://dx.doi.org/10.3329/cardio.v1i2.8179 Cardiovasc. j. 2009; 1(2) : 237-239

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Native Valve Endocarditis due toRalstonia pickettii: A Case Report and Literature Review

Case Reports in Infectious Diseases ◽

10.1155/2015/324675 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9

Author(s):

Joseph Orme ◽

Tomas Rivera-Bonilla ◽

Akil Loli ◽

Negin N. Blattman

Keyword(s):

Case Report ◽

Infective Endocarditis ◽

Aortic Valve ◽

Literature Review ◽

Heart Block ◽

Complete Heart Block ◽

Healthy Individuals ◽

Native Valve ◽

Native Valve Endocarditis ◽

First Case

Ralstonia pickettiiis a rare pathogen and even more rare in healthy individuals. Here we report a case ofR. pickettiibacteremia leading to aortic valve abscess and complete heart block. To our knowledge this is the first case report ofRalstoniaspecies causing infective endocarditis with perivalvular abscess.

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Chest palpitations in a teenager as an unusual presentation of Lyme disease: case report

BMC Infectious Diseases ◽

10.1186/s12879-020-05438-0 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Faith Myers ◽

Pooja E. Mishra ◽

Daniel Cortez ◽

Mark R. Schleiss

Keyword(s):

Chest Pain ◽

Lyme Disease ◽

Antibiotic Therapy ◽

Heart Block ◽

Left Ventricular ◽

Uneventful Recovery ◽

Lyme Carditis ◽

Cardiac Symptoms ◽

Disease Case ◽

Pr Interval

Abstract Background The incidence of Lyme disease (LD) in North America has increased substantially in the past two decades. Concomitant with the increased incidence of infection has been an enhancement in the recognition of LD complications. Here, we report a case of Lyme carditis complicated by heart block in a pediatric patient admitted to our children’s hospital. What is unique about this case is that the complaint of chest palpitations is an infrequent presentation of LD, and what it adds to the scientific literature is an improved understanding of LD in the pediatric population. Case presentation The patient was a 16-year-old male who presented with the main concerns of acute onset of palpitations and chest pain. An important clinical finding was Erythema migrans (EM) on physical exam. The primary diagnoses were LD with associated Lyme carditis, based on the finding of 1st degree atrioventricular heart block (AVB) and positive IgM and IgG antibodies to Borrelia burgdorferi. Interventions included echocardiography, electrocardiography (EKG), and intravenous antibiotics. The hospital course was further remarkable for transition to 2nd degree heart block and transient episodes of complete heart block. A normal sinus rhythm and PR interval were restored after antibiotic therapy and the primary outcome was that of an uneventful recovery. Conclusions Lyme carditis occurs in < 5% of LD cases, but the “take-away” lesson of this case is that carditis can be the presenting manifestation of B. burgdorferi infection in pediatric patients. Any patient with suspected Lyme carditis manifesting cardiac symptoms such as syncope, chest pain, or EKG changes should be admitted for parenteral antibiotic therapy and cardiac monitoring. The most common manifestation of Lyme carditis is AVB. AVB may manifest as first-degree block, or may present as high-grade second or third-degree block. Other manifestations of Lyme carditis may include myopericarditis, left ventricular dysfunction, and cardiomegaly. Resolution of carditis is typically achieved through antibiotic administration, although pacemaker placement should be considered if the PR interval fails to normalize or if higher degrees of heart block, with accompanying symptoms, are encountered. With the rising incidence of LD, providers must maintain a high level of suspicion in order to promptly diagnose and treat Lyme carditis.

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