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Lyme Carditis in Hospitalized Children and Adults, a Case Series

Richard V Shen1, Carol A McCarthy2, Robert P Smith1

  • 1Division of Infectious Diseases, Maine Medical Center, Portland, Maine, USA.

Open Forum Infectious Diseases
|July 12, 2021
PubMed

Insights

Early recognition of Lyme disease is crucial. This study found that Lyme carditis, a heart complication of Lyme disease, was often misdiagnosed in outpatient settings, delaying treatment for pediatric and adult patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Lyme carditis is a rare but serious complication of Lyme disease.
  • Understanding its presentation and outcomes in different age groups is important for clinical practice.

Purpose of the Study:

  • To compare the presentation, management, and outcomes of Lyme carditis in pediatric versus adult populations.
  • To identify factors contributing to delayed diagnosis and treatment.

Main Methods:

  • Retrospective analysis of pediatric and adult patients hospitalized with Lyme carditis and heart block.
  • Inclusion criteria: PR interval >300 ms and positive Lyme serologies.
  • Data collected on medical history, clinical presentation, treatment, and outcomes.

Main Results:

  • 30 patients (10 children, 20 adults) admitted for Lyme carditis.
  • Most patients were male with no prior cardiac history.
  • 41% had Lyme disease suspected in outpatient settings; only 12% received treatment.
  • Children more frequently presented with disseminated erythema migrans and fever.
  • Mobitz type 2 heart block more prevalent in adults; first-degree more in children.
  • 27/30 patients improved heart block; 3 adults required pacemakers.
  • One death occurred in the series.

Conclusions:

  • Lyme carditis predominantly affects younger males.
  • Many patients experience persistent heart block upon discharge.
  • Delayed diagnosis and treatment in outpatient settings are common.
  • Improved early recognition and management of Lyme disease could reduce Lyme carditis incidence.
Abstract

Keywords:
Lymeadultcarditisoutcomespediatric

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