EJMCR |

Case Report

Volume: 6 | Issue: 5 | Published: Aug 16, 2022 | Pages: 84 - 86 | DOI: 10.24911/ejmcr/173-1646534187

Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report

Authors: Adam G. Clements , Mercedes Miller , Brittany Myszka

Authors

Adam G. Clements

Department of Family Medicine, Aspirus Wausau Hospital, Wausau, WI, USA, Medical College of Wisconsin, Wausau, WI, USA, Wisconsin and Central Wisconsin GME Consortium, Wausau, WI, USA

ORCID

Mercedes Miller

Medical College of Wisconsin, Wausau, WI, USA

Brittany Myszka

Wisconsin and Central Wisconsin GME Consortium, Wausau, WI, USA

Publication History

Received: March 06, 2022

Accepted: August 01, 2022

Published: August 16, 2022

Abstract

Background: Lyme disease is a common parasitic disease that can cause varied and potentially serious manifestations. The recommendations for treating some manifestations of Lyme are based on low-quality evidence, including for myocarditis. Treatment guidelines vary and are based on very low-quality evidence. IV ceftriaxone is typically recommended until the heart block resolves. Case Presentation: We report a case of a 31-year-old male admitted to our inpatient service with syncope and bradycardia. He was diagnosed with a third-degree heart block from Lyme disease. He was started on IV ceftriaxone, and his heart block improved. He had an ongoing second-degree atrioventricular block when he requested to be discharged on oral antibiotics rather than continuing IV ceftriaxone. Our patient received four doses of ceftriaxone before discharging from the hospital. He completed 2 weeks of oral doxycycline after discharge. In a follow-up phone call, he reported complete resolution of symptoms. Conclusion: This case supports the current Infectious Disease Society of America guideline of using intravenous ceftriaxone followed by oral doxycycline after the patient has improved. It also suggests that it may be safe to shorten the period of intravenous antibiotics and hospitalization. Shortening this period would reduce expenses and be more convenient for patients. More research is needed on the duration and preferred agent for treating the complications of Lyme.

Keywords: Lyme, heart block, myocarditis, case report, doxycycline, green

Pubmed Style

Adam G. Clements, Mercedes Miller, Brittany Myszka. Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report. EJMCR. 2022; 16 (August 2022): 84-86. doi:10.24911/ejmcr/173-1646534187

Web Style

Adam G. Clements, Mercedes Miller, Brittany Myszka. Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report. https://ejmcr.com/articles/1278 [Access: December 25, 2024]. doi:10.24911/ejmcr/173-1646534187

AMA (American Medical Association) Style

Vancouver/ICMJE Style

Adam G. Clements, Mercedes Miller, Brittany Myszka. Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report. EJMCR. (2022), [cited December 25, 2024]; 16 (August 2022): 84-86. doi:10.24911/ejmcr/173-1646534187

Harvard Style

Adam G. Clements, Mercedes Miller, Brittany Myszka (2022) Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report. EJMCR, 16 (August 2022): 84-86. doi:10.24911/ejmcr/173-1646534187

Chicago Style

Adam G. Clements, Mercedes Miller, Brittany Myszka. "Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report." 16 (2022), 84-86. doi:10.24911/ejmcr/173-1646534187

MLA (The Modern Language Association) Style

APA (American Psychological Association) Style

Adam G. Clements, Mercedes Miller, Brittany Myszka (2022) Lyme myocarditis with third-degree heart block successfully treated with an early transition from IV ceftriaxone to oral doxycyclinecase report. , 16 (August 2022), 84-86. doi:10.24911/ejmcr/173-1646534187