Lyme carditis

From IDWiki

Clinical Manifestations

  • Occurs during early disseminated Lyme disease (14-21 days following inoculation)

Management

  • Treat per Borrelia burgdorferi
    • Hospitalization recommended for those at risk of severe complications
      • PR > 300 ms, arrhythmias, myopericarditis
      • Continuous ECG monitoring
    • For symptomatic bradycardia refractory to medical management, use temporary rather than permanent pacing
    • Prefer oral antibiotics in general (doxycycline, amoxicillin, cefuroxime, or azithromycin)
      • If hospitalized, start with ceftriaxone before stepping down to oral
      • Duration of 14 to 21 days
  • About half need temporary pacing
  • Third-degree heart block resolves with treatment and they do not need a pacemaker