Pediatr Infect Vaccine.  2020 Dec;27(3):184-189. 10.14776/piv.2020.27.e20.

A Case of Lyme Disease Complicated with Atrioventricular Block in a 13-year-old Boy

• Ahn B
• Kim GB
• Lee HJ
• Choi EH

• KMID: 2511821
• DOI: http://doi.org/10.14776/piv.2020.27.e20

Abstract

Lyme disease is a common vector-borne disease caused by Borrelia burgdorferi. Erythema migrans represents the most common manifestation during the early phase of this disease; however, systemic manifestations involving the nervous system, joints, or heart are known to occur. We report a case of Lyme disease accompanied by cardiac complications in a 13-year-old Korean male adolescent. The patient developed annular erythematous lesions on his lower extremities after a field trip during his visit to Connecticut, USA, for a boarding school camp, and his skin lesions were consistent with erythema migrans. Indirect immunofluorescence assay and Western blot analysis for Lyme immunoglobulin M showed positive results. Electrocardiography revealed a first-degree atrioventricular block, and he was diagnosed with Lyme carditis and received a 4-week course of oral doxycycline. Follow-up electrocardiography performed a week later revealed normal findings, and the patient showed an uneventful recovery. Lyme carditis often presents as an asymptomatic heart block that can progress to an advanced heart block; however, this condition is reversible with appropriate antibiotic treatment.

Keyword

Lyme disease; Lyme carditis; Atrioventricular block