June 1991

Complete Heart Block as the Sole Presentation of Lyme Disease

Author Affiliations

Angouleme, France

Poitiers, France

Arch Intern Med. 1991;151(6):1240. doi:10.1001/archinte.1991.00400060146043

To the Editor. —  It was with great interest and concern that we read the recent article by Kimball and coworkers.1 In their article entitled "Complete Heart Block as the Sole Presentation of Lyme Disease," they affirmed that there is only one previously published case of Lyme disease presenting solely as high-grade atrioventricular block without other characteristics of the disease.2 Thus, they seem to ignore two other cases.3 Kapusta and coworkers3 described two cases of patients presenting for weakness and easy fatigability for whom the 12-lead electrocardiogram revealed high second-degree heart block. A positive diagnosis was ensured by the notion of a tick bite occurring 4 and 3 weeks before, and by the positive presence of Borrelia burgdorferi serologic test results. The normalization of the electrocardiogram was obtained under 8 and 3 days by doxycycline therapy.We wish to add another personal case4,5 of a

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