Lyme disease and Lyme carditis

We discussed a case of a previously healthy young man who presented with recent travel history to the NE United States, subacute-chronic myalgias & headaches, acute left Bell’s palsy, and acute palpitations, found to have sinus and AV nodal disease due to Lyme disease

Lyme carditis

  • Presented <1-28 weeks after infection onset
  • AV conduction block of varying severity is usually more common than sinus node & distal conduction system disease
  • ↑ risk of complete AV block if PR > 300 ms
  • Treatment:
    • If PR > 300 ms:  IV penicillin or IV ceftriaxone x28 days
    • If PR < 300 ms:  PO antibiotics (e.g. doxycycline x14-28 days)

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