[Second-degree atrioventricular block caused by Lyme disease].

Autor:	van der Zande JMJ; Amsterdam UMC, Afd. Cardiologie., Baarsma ME; Amsterdam UMC, Afd. Interne Geneeskunde., Grundeken MJ; Amsterdam UMC, Afd. Cardiologie., Verhaar N; Amsterdam UMC, Afd. Medische Microbiologie., Kok WEM; Amsterdam UMC, Afd. Cardiologie., Hovius JW; Amsterdam UMC, Afd. Interne Geneeskunde.; Contact: J. W. Hovius (lyme@amsterdamumc.nl).
Jazyk:	Dutch; Flemish
Zdroj:	Nederlands tijdschrift voor geneeskunde [Ned Tijdschr Geneeskd] 2020 Jan 24; Vol. 164. Date of Electronic Publication: 2020 Jan 24.
Abstrakt:	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.
Databáze:	MEDLINE
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