Published online May 26, 2013. doi: 10.4330/wjc.v5.i5.148
Revised: April 10, 2013
Accepted: April 18, 2013
Published online: May 26, 2013
Processing time: 143 Days and 19.7 Hours
Although Lyme carditis is relatively rare within 4-6 wk of exposure, it can uncommonly present as the first sign of disseminated Lyme disease. Here we present 17 year old boy who presented to the emergency department with chest discomfort and was later found to have complete atrioventricular block due to lyme carditis. He had uneventful recovery after empiric treatment with ceftriaxone. Our case highlights the importance of considering reversible causes of complete AV block since appropriate therapy can avoid the need for permanent pacemaker insertion.
Core tip: Seventeen-year man presented with acute chest discomfort following a tick bite 5 wk back. His hospital course was complicated with the development of first degree AV block which rapidly deteriorated to total AV block. Due to high grade of suspicion of lyme disease and positive lyme enzyme-linked immunosorbent assay and Lyme IgM (Western blotting), treatment with Ceftriaxone and doxycycline was started with complete remission. It is important to consider the reversible causes of complete AV block since appropriate therapy can avoid the need for permanent pacemaker insertion.