Błaut-Jurkowska Justyna, Olszowska Maria, Kaźnica-Wiatr Magdalena, Podolec Piotr
Department of Cardiac and Vascular Diseases, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Cracow, Poland.
Pol Merkur Lekarski. 2015 Aug;39(230):111-5.
Lyme disease is a multisystem infectious disease caused by the spirochete Borrelia burgdorferi. A steady increase in the number of cases is noticed both in Poland and Europe. Cardiac involvement in the course of borreliosis is relatively rare. It is estimated that it concerns about 0.5-10% of patients with Lyme disease. Cardiac involvement generally occurs in the early phase of illness. The most common manifestation of Lyme carditis are transient conduction abnormality, arrhythmias, myocarditis and pericarditis. The basic method of treatment Lyme carditis are antibiotics. The clinical course is usually benign. In most cases a complete recovery is observed. However, in a small proportion of patients dilated cardiomyopathy may occur. Furthermore, death from Lyme carditis has been reported. Lyme carditis remains a real diagnostic and therapeutic challenge for clinicians. Factors that can make the diagnosis difficult are: atypical clinical picture, negation of tick bite, the absence of erythema migrans, onset of symptoms outside the period of tick activity and negative serological results in the initial stage of the disease.
莱姆病是一种由伯氏疏螺旋体引起的多系统感染性疾病。在波兰和欧洲,该病的病例数均呈稳步上升趋势。心脏受累在莱姆病病程中相对少见。据估计,约0.5% - 10%的莱姆病患者会出现心脏受累情况。心脏受累通常发生在疾病早期。莱姆病心脏炎最常见的表现是短暂性传导异常、心律失常、心肌炎和心包炎。治疗莱姆病心脏炎的基本方法是使用抗生素。临床病程通常是良性的。在大多数情况下,患者可完全康复。然而,一小部分患者可能会发生扩张型心肌病。此外,已有莱姆病心脏炎导致死亡的报道。莱姆病心脏炎对临床医生来说仍然是一个实实在在的诊断和治疗挑战。可能导致诊断困难的因素包括:非典型临床表现、否认蜱叮咬史、无游走性红斑、在蜱活动期之外出现症状以及疾病初期血清学结果为阴性。