- Lyme disease also known as "Lyme borreliosis" [1]
- Lyme disease is a systemic illness caused by the spirochete Borrelia burgdorferi [3]
- caused by bacteria of the Borrelia type which is spread by ticks [1]
- The most common sign of infection is an expanding area of redness on the skin, known as erythema migrans [1]
- Blood test - Screening Lyme serology - positive [2]
- Lyme carditis is a complication of Lyme disease [3]
- The Lyme bacterium can infect all parts of the heart, including the conduction system around the atrioventricular node, the outer or inner membranes of the heart, the cardiac muscle [4]
- impairment of conduction system cause heart block [ 1st degree, 2nd degree and complete heart block]
- Ceftriaxone started after 24 hours rash is resolved [2]
- After 48 hours of observation, he underwent a temporary VVI (ventricular pacing and sensing mode) pacemaker insertion [2]
- On ceftriaxone, the AV block converted to first degree 2 days after starting antibiotics and then completely resolved by day 11, at which point the pacemaker was removed [2]
- He completed a total 21-day course of treatment with oral doxycycline [2]
References
- Lyme disease - Wikipedia
- Case of Reversible Complete Heart Block - The American Journal of Medicine, Vol 130, No 8, August 2017
- Lyme carditis with complete heart block: management with an external pacemaker, Muhammad Ali Chaudhry. Pubmed
- Lyme Disease and the Heart. - Peter J. Krause, Linda K. Bockenstedt. Circulation, 2013
