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Persistent atrioventricular block in Lyme borreliosis

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Summary

Cardiac manifestations are reported in 0.3%–4.0% of European patients withBorrelia burgdorferi (B.b.) infection. Usually symptoms disappear within 6 weeks. We report a case with persistent impairment of atrioventricular (AV) conduction. Diagnosis was confirmed by demonstration of IgM antibodies and increase of IgG antibody titers against B.b. in serum, by isolation of the spirochete from skin biopsy material and by the typical clinical combination of erythema migrans, Bannwarth syndrome (meningoradiculitis), and complete heart block. Despite immediate antibiotic therapy with ceftriaxone, first degree AV block and second degree block Wenckebach with atrial pacing at 100 beats/minute persisted for 2 years. We conclude, that Lyme carditis can cause long-standing or irreversible AV conduction defects despite adequate and early antimicrobial therapy.

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Abbreviations

AV:

atrioventricular

AVt:

atrioventricular time

B. burgdorferi :

Borrelia burgdorferi

CSF:

cerebrospinal fluid

ECG:

electrocardiogram

ESR:

erythrocyte sedimentation rate

FRG:

Federal Republic of Germany

I. dammini/ricinus:

Ixodes dammini/ricinus

IgG:

immunoglobulin G

IgM:

immunoglobulin M

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Authors and Affiliations

  1. Krankenhaus München-Schwabing, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, Deutschland

    W. Mayer, F. X. Kleber, W. Maciejewski, H. Sigl, E. Holzer & W. Doering

  2. Max von Pettenkofer-Institut für Hygiene und Medizinische Mikrobiologie der Ludwig-Maximilians-Universität München, Deutschland

    B. Wilske & V. Preac-Mursic

Authors
  1. W. Mayer
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  2. F. X. Kleber
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  3. B. Wilske
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  4. V. Preac-Mursic
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  5. W. Maciejewski
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  6. H. Sigl
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  7. E. Holzer
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  8. W. Doering
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Mayer, W., Kleber, F.X., Wilske, B. et al. Persistent atrioventricular block in Lyme borreliosis. Klin Wochenschr 68, 431–435 (1990). https://doi.org/10.1007/BF01648587

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  • DOI: https://doi.org/10.1007/BF01648587

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