Generic Portal

TY - JOUR

T1 - Tweedegraads atrioventriculair blok door lymeziekte

AU - van der Zande, J M J

AU - Baarsma, M E

AU - Grundeken, M J

AU - Verhaar, N

AU - Kok, W E M

AU - Hovius, J W

PY - 2020/1/24

Y1 - 2020/1/24

N2 - 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.

AB - 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.

KW - Anti-Bacterial Agents/therapeutic use

KW - Atrioventricular Block/microbiology

KW - Borrelia burgdorferi

KW - Ceftriaxone/therapeutic use

KW - Europe

KW - Humans

KW - Lyme Disease/complications

KW - Male

KW - Middle Aged

KW - Pacemaker, Artificial

M3 - Article

C2 - 32186826

VL - 164

JO - Nederlands tijdschrift voor geneeskunde

JF - Nederlands tijdschrift voor geneeskunde

SN - 0028-2162

ER -