Application of diagnostic methods in the verification of Lyme carditis (clinical case)

K.V.  Myndziv; N.I. Yarema; N.Ya. Vereshchahina; V.I. Bondarchuk; U.P. Hevko; O.V.  Vayda

doi:10.26641/2307-0404.2023.3.289228

Authors

K.V. Myndziv I. Horbachevsky Ternoil National Medical University, Maydan Voli str., 1, Ternopil, 46001, Ukraine https://orcid.org/0000-0003-1025-973X
N.I. Yarema I. Horbachevsky Ternopil National Medical University, Maidan Voli, 1, Ternopil, 46001, Ukraine https://orcid.org/0000-0002-4378-1084
N.Ya. Vereshchahina I. Horbachevsky Ternopil National Medical University, Maidan Voli, 1, Ternopil, 46001, Ukraine https://orcid.org/0000-0002-5569-1334
V.I. Bondarchuk I. Horbachevsky Ternopil National Medical University, Ukraine https://orcid.org/0000-0001-6906-2494
U.P. Hevko I. Horbachevsky Ternopil National Medical University, Maidan Voli, 1, Ternopil, 46001, Ukraine https://orcid.org/0000-0001-5265-2842
O.V. Vayda I. Horbachevsky Ternopil National Medical University, Maidan Voli, 1, Ternopil, 46001, Ukraine https://orcid.org/0000-0002-2476-7850

DOI:

https://doi.org/10.26641/2307-0404.2023.3.289228

Keywords:

Lyme disease, myocarditis, AV-block, serological testing, Holter monitoring, ultrasonography, magnetic resonance imaging

Abstract

The aim of the reserch was to investigate the genotype of the pathogen in a patient with Lyme carditis and to analyze the course of the disease in the process of etiotropic treatment. The article describes a clinical case of infectious myocarditis associated with Lyme disease in a 49-year-old patient. The value of modern diagnostics technologies in diagnosis determination was described. The course of the disease and the results of treatment of the patient were analyzed. The severe rhythm and conduction disorders were revealed with the method of Holter monitoring: AV-block of the first degree, transient AV-block of the II degree (Mobitz 2) and III degree, polytopic extrasystoles. The morphological changes in the heart were diagnosed with ultrasonography and cardiac MRI in order to confirm the diagnosis and to monitor the patient's subsequent course. Total antibodies to antigens of the B. burgdorferi sensu lato complex in blood serum were determined by the ELISA method with test systems Euroimmun AG (Germany). At the second stage, the immunoblot method was applied using the EUROLINE Borrelia RN-AT test system. Due to timely diagnosis, including serological, prescribed etiotropic antibacterial treatment, the patient achieved a significant improvement in both clinical condition and positive serological and ECG dynamics with improved AV conduction. The most frequent ECG changes in Lyme carditis are conduction disorders with development of blockades of various stages. The application of the modern technologies in patients with myocarditis made it possible to determine the etiological factor of the disease with the establishment of genotypes, which caused Lyme carditis.

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