{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T07:43:42Z","timestamp":1780472622398,"version":"3.54.1"},"reference-count":16,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T00:00:00Z","timestamp":1616457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Lyme carditis is an uncommon manifestation of Lyme disease. This report compares Lyme carditis presentation, management, and outcomes in pediatric and adult populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Charts of pediatric and adult patients with heart block (PR interval\u2005&amp;gt;300 ms) and positive Lyme serologies hospitalized in Portland, Maine, between January 2010 and December 2018 were analyzed. Data on medical history, presentation, treatment, and outcomes are described.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ten children and 20 adults were admitted for Lyme carditis between June and October. Ninety percent were male, and 87% had no prior cardiac history. Seventeen had outpatient evaluation before admission. Of these, a minority (41%) had Lyme disease suspected in the outpatient setting, and fewer (12%) were initiated on Lyme disease treatment. The most common alternate diagnoses were viral illness and erythema multiforme. More children than adults had disseminated erythema migrans and fever. First-degree heart block was more prevalent in children, and Mobitz type 2 heart block was more prevalent in adults. Ten patients presented with syncope. Proportionately more adults needed temporary pacing. Children had shorter antibiotic durations compared with adults. Of the 30 cases, 27 had improved heart block, while 3 adults required a pacemaker at discharge. Nine children and 14 adults were discharged with a PR 200\u2013300 ms. There was a single death in this series.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Cases tended to be younger males. Most patients had some heart block on discharge. Of patients evaluated as outpatients, Lyme disease was suspected in 41%. Improved early recognition and treatment of Lyme disease may decrease Lyme carditis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ofid\/ofab140","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T12:37:18Z","timestamp":1616503038000},"source":"Crossref","is-referenced-by-count":15,"title":["Lyme Carditis in Hospitalized Children and Adults, a Case Series"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3623-3581","authenticated-orcid":false,"given":"Richard V","family":"Shen","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Maine Medical Center, Portland, Maine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A","family":"McCarthy","sequence":"additional","affiliation":[{"name":"Division of Pediatric Infectious Diseases, Maine Medical Center, Portland, Maine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Maine Medical Center, Portland, Maine, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,3,23]]},"reference":[{"issue":"1_Part_1","key":"2021070901201205100_CIT0001","doi-asserted-by":"crossref","first-page":"8","DOI":"10.7326\/0003-4819-93-1-8","article-title":"Lyme carditis: cardiac abnormalities of Lyme disease","volume":"93","author":"Steere","year":"1980","journal-title":"Ann Intern Med"},{"key":"2021070901201205100_CIT0002","doi-asserted-by":"crossref","first-page":"e835","DOI":"10.1542\/peds.2008-3058","article-title":"Lyme carditis in children: presentation, predictive factors, and clinical course","volume":"123","author":"Costello","year":"2009","journal-title":"Pediatrics"},{"key":"2021070901201205100_CIT0003","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.idc.2015.02.003","article-title":"Lyme carditis","volume":"29","author":"Robinson","year":"2015","journal-title":"Inf Dis Clin North Am"},{"key":"2021070901201205100_CIT0004","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/0002-8703(91)90589-A","article-title":"Cardiovascular manifestations of Lyme disease","volume":"122","author":"Cox","year":"1991","journal-title":"Am Heart J"},{"key":"2021070901201205100_CIT0005","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.idc.2007.12.008","article-title":"Lyme carditis","volume":"22","author":"Fish","year":"2008","journal-title":"Inf Dis Clin North Am"},{"key":"2021070901201205100_CIT0006","doi-asserted-by":"crossref","first-page":"996","DOI":"10.1093\/cid\/ciu411","article-title":"Third-degree heart block associated with lyme carditis: review of published cases","volume":"59","author":"Forrester","year":"2014","journal-title":"Clin Inf Dis"},{"key":"2021070901201205100_CIT0007","first-page":"982","article-title":"Notes from the field: update on Lyme carditis, groups at high risk, and frequency of associated sudden cardiac death\u2014United States","volume":"63","author":"Forrester","year":"2014","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021070901201205100_CIT0008","first-page":"993","article-title":"Three sudden cardiac deaths associated with Lyme carditis - United States, November 2012-July 2013","volume":"62","year":"2013","journal-title":"MMWR"},{"key":"2021070901201205100_CIT0009","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1136\/pgmj.66.772.134","article-title":"Fatal Lyme carditis and endodermal heterotopia of the atrioventricular node","volume":"66","author":"Cary","year":"1990","journal-title":"Pos Medical J"},{"key":"2021070901201205100_CIT0010","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.1016\/j.ajpath.2015.12.027","article-title":"Cardiac tropism of Borrelia burgdorferi: an autopsy study of sudden cardiac death associated with Lyme carditis","volume":"186","author":"Muehlenbachs","year":"2016","journal-title":"Am J Pathol"},{"key":"2021070901201205100_CIT0011","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1016\/0002-9343(91)90619-9","article-title":"Irreversible complete heart block in Lyme disease.","volume":"90","author":"Artigao","year":"1991","journal-title":"Am J Med"},{"key":"2021070901201205100_CIT0012","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"2021070901201205100_CIT0013","first-page":"1","article-title":"Case definitions for public health surveillance","volume":"39","author":"Wharton","year":"1990","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021070901201205100_CIT0014","first-page":"590","article-title":"Notice to readers: recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease","volume":"44","author":"Centers for Disease Control and Prevention.","year":"1995","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2021070901201205100_CIT0015","first-page":"81","article-title":"Lyme carditis: clinical characteristics of 105 cases","volume":"77","author":"van der Linde","year":"1991","journal-title":"Scand J Inf Dis Sup"},{"key":"2021070901201205100_CIT0016","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1086\/649920","article-title":"Antibiotic treatment duration and long-term outcomes of patients with early Lyme disease from a Lyme disease-hyperendemic area","volume":"50","author":"Kowalski","year":"2010","journal-title":"Clin Inf Dis"}],"container-title":["Open Forum Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ofid\/advance-article-pdf\/doi\/10.1093\/ofid\/ofab140\/36670601\/ofab140.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/8\/7\/ofab140\/38885477\/ofab140.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ofid\/article-pdf\/8\/7\/ofab140\/38885477\/ofab140.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T07:41:40Z","timestamp":1625816500000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ofid\/article\/doi\/10.1093\/ofid\/ofab140\/6182535"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,23]]},"references-count":16,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ofid\/ofab140","relation":{},"ISSN":["2328-8957"],"issn-type":[{"value":"2328-8957","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,7,1]]},"published":{"date-parts":[[2021,3,23]]},"article-number":"ofab140"}}