Borrelia infection as a cause of carditis (A long-term study)

Background: Although the frequency of Lyme carditis is not high, it is one of the most challenging conditions in terms of diagnosis. No long-term stud ies that would help expand our body of knowledge concerning the circumstanc es of its development and the natural course of this form of Lyme borrelios is (LB), the most widespread anthropozoonosis in Central Europe, have been reported to date. Aim: The authors sought to describe and assess the consequences of a less c ommon form of Lyme carditis (LC). An assessment of the following aspects wa s made: a) the forms, natural history and sequelae of the less common clini cal appearances of LC, 6) the role of antibiotic therapy with reference to the late manifestations of LB. Methods: Three patients were selected from a group of 60 consecutive patien ts with demonstrated LC during a follow-up period from 1987 to 2000. Patien t no. 1 was being followed for myocarditis with frequent Ventricular extras ystoles, patient no. 2 for pericarditis, and patient no. 3 for dilated card iomyopathy as a late manifestation of LB. In addition to routine examinatio n at entry, the patients were subjected to a standard 12-lead EGG, continuo us 24-hour Holter ECG monitoring, exercise testing (bicycle ergometry), inv estigations of antibodies using ELISA and Western blot, investigation of th yroid (T3,T4,TSH tests) and mineral levels. Results: The study showed no significant correlation between the clinical c ourse and levels of specific antibodies. It confirmed the concept that inad equate or no therapy with antibiotics in the initial stage or the disease h as a significant effect on the development of late sequelae. Conclusion: Based on the long-term treatment of three patients with less co mmon, yet clinically urgent findings, the authors conclude that even a rela tively serious clinical course is associated with no major limitations for affected individuals after an interval of several years.