Think outside the heart! Case report of Lyme disease

Area of Science:

• Infectious Diseases
• Cardiology
• Neurology

Background:

• Lyme carditis can present with atrioventricular block.
• Drug abuse can complicate clinical presentations and diagnostic pathways.

Observation:

• A young patient with a history of drug abuse presented with high-degree atrioventricular block.
• Initial diagnosis focused on cardiac manifestations, attributing symptoms to Lyme carditis.

Findings:

• Antibiotic therapy led to the regression of atrioventricular block.
• Concomitant Lyme-meningoencephalitis was diagnosed late due to a focus on cardiac symptoms and patient's drug abuse history.

Implications:

• Early and comprehensive diagnostic evaluation is crucial, even in patients with confounding factors like drug abuse.
• Cardiologists should consider broader differential diagnoses beyond cardiac manifestations in suspected Lyme disease cases.
• Timely diagnosis of neurological involvement in Lyme disease is essential to prevent long-term complications.