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Publications > Détail

E.TARPINIAN, J.ROBERT,C.BRAUSTEIN,S.IN, B.POUGET (2000)

COMPLETE TRANSITORY ATRIOVENTRICULARBLOCK IN LYME DISEASE

Résumé :

Lyme disease is a tick-borne spirochetal infection caused by borrelia burgdofery never described in New Caledonia. Lyme carditis are uncommon but the most frequent and typical cardiac manifestations is in the form of conduction system disorders. We report a case of transient third-degree atrio-ventricular block in a patient admitted for a syncope and required isoprenaline infusion. Three weeks after coming back from a Sologne's journey in France, a 32 years old man was admitted in Cardiology Department for a syncope. ECG revealed a 3 degrees atrioventricular block responsive to drug treatment (isoprenaline). Erythema migrans five weeks before admission and the knowledge of an insect bite on his leg and a recent borreliosis epidemic in Sologne suggested lyme carditis. The diagnosis was confirmed serologically (Elisa increased polyvalently.IgM and IgG antibodies were positive). On antibiotic treatment with ceftriaxone(2 g daily) and prednisolone (80 mg daily with gradual dose reduction) , the complete AV block regressed within 5 day of the start of tretment and sinus rhythm was permanently re-established (isoprenaline stopped within 3 days). This case report illustrates that transitory AV block can be the only manifestation of sporadic lyme disease and the diagnosis made on serological grounds. Diagnosis is all the more difficult in New Caledonia as we dont'have borrelia tick'transmission known in the country;

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