Mayer W, Kleber F X, Wilske B, Preac-Mursic V, Maciejewski W, Sigl H, Holzer E, Doering W
Krankenhaus München-Schwabing, Akademisches Lehrkrankenhaus, Ludwig-Maximilians-Universität München.
Klin Wochenschr. 1990 Apr 17;68(8):431-5. doi: 10.1007/BF01648587.
Cardiac manifestations are reported in 0.3%-4.0% of European patients with Borrelia burgdorferi (B.b.) infection. Usually symptoms disappear within 6 weeks. We report a case with persistent impairment of atrioventricular (AV) conduction. Diagnosis was confirmed by demonstration of IgM antibodies and increase of IgG antibody titers against B.b. in serum, by isolation of the spirochete from skin biopsy material and by the typical clinical combination of erythema migrans, Bannwarth syndrome (meningoradiculitis), and complete heart block. Despite immediate antibiotic therapy with ceftriaxone, first degree AV block and second degree block Wenckebach with atrial pacing at 100 beats/minute persisted for 2 years. We conclude, that Lyme carditis can cause long-standing or irreversible AV conduction defects despite adequate and early antimicrobial therapy.
据报道，在欧洲感染伯氏疏螺旋体（B.b.）的患者中，心脏表现的发生率为0.3%-4.0%。通常症状会在6周内消失。我们报告了一例房室（AV）传导持续受损的病例。通过血清中针对B.b.的IgM抗体的检测以及IgG抗体滴度的升高、从皮肤活检材料中分离出螺旋体以及游走性红斑、班氏综合征（脑脊神经根炎）和完全性心脏传导阻滞的典型临床组合，确诊了该病。尽管立即使用头孢曲松进行了抗生素治疗，但一度房室传导阻滞和伴有100次/分钟心房起搏的二度文氏阻滞持续了2年。我们得出结论，尽管进行了充分且早期的抗菌治疗，莱姆心肌炎仍可导致长期或不可逆的房室传导缺陷。
