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Lyme Carditis Presenting With Complete Heart Block in a Patient Who Received a Heart Transplant

Wong, Darren W. MD*; Apostolidou, Eirini MD*; Bruno, Christopher MD

Infectious Diseases in Clinical Practice: September 2013 - Volume 21 - Issue 5 - p e30–e31
doi: 10.1097/IPC.0b013e31827ce6e3
Case Reports

In immunocompetent patients, Lyme carditis is a well-established complication of untreated primary Lyme disease. Whether the presentation and course of Lyme disease differs in immunosuppressed patients has not been well established. There are rare case reports of Lyme disease presenting after solid organ transplantation. We describe a case of Lyme carditis in a patient who received a heart transplant presenting as complete heart block progressing to symptomatic heart failure. The patient required permanent dual-chamber pacemaker placement for cardiac synchronization; however, after treatment with intravenous ceftriaxone, she regained an intrinsic sinus rhythm. Practitioners should maintain a high index of suspicion for Lyme disease when assessing immunosuppressed patients with new-onset heart block. The classic manifestations of primary Lyme disease may be absent as was the case in this patient.

From the *Department of Internal Medicine and †Division of Infectious Diseases and HIV Medicine, Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA.

Correspondence to: Darren W. Wong, MD, Department of Internal Medicine, Drexel University College of Medicine, Philadelphia, PA. E-mail: dwong@drexelmed.edu.

The authors have no funding or conflicts of interest to disclose.

© 2013 by Lippincott Williams & Wilkins.