Abstract:
Lyme disease is a progressive infectious disease caused by the Borrelia species that affects multiple organ systems, including the brain, heart, skin, and musculoskeletal systems. The cardiac manifestations of Lyme disease typically present with atrioventricular nodal conduction abnormalities and, more rarely, myocarditis. We report a case of an immunocompromised 57-year-old woman who presented with acute onset shortness of breath, hypervolemia, injective conjunctiva, and global vision loss of the left eye in the setting of a recent tick bite. Serologic testing confirmed borreliosis, and cardiac testing demonstrated acute isolated systolic heart failure without any cardiac conduction system abnormalities on the electrocardiogram. The diagnosis of Lyme carditis was made, and the patient was started on doxycycline with complete recovery of cardiac systolic function. This case demonstrates atypical cardiac manifestations of Lyme disease and highlights the difficulty in workup and understanding of Lyme carditis particularly in immunocompromised patients.
摘要:
莱姆病是由疏螺旋体引起的进行性传染病,影响多个器官系统,包括大脑,心,皮肤,和肌肉骨骼系统.莱姆病的心脏表现通常表现为房室结传导异常,很少,心肌炎.我们报告了一例免疫功能低下的57岁女性,她出现急性呼吸急促,血容量过高,射血结膜,以及在最近的蜱叮咬中左眼的全球视力丧失。血清学检测证实了伯氏螺旋体病,和心脏测试显示急性孤立性收缩性心力衰竭,心电图上没有任何心脏传导系统异常。诊断为莱姆病心炎,患者开始使用多西环素,心脏收缩功能完全恢复。此病例证明了莱姆病的非典型心脏表现,并强调了对莱姆病的检查和理解的困难,尤其是在免疫功能低下的患者中。