{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T11:36:40Z","timestamp":1792669000704,"version":"4.5.0"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":25,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Carditis is a rare complication of Lyme disease and usually presents in the early dissemination phase, several weeks after exposure to a tick bite. Conduction abnormalities are the most common manifestation of Lyme carditis. The presentation can vary from atrioventricular conduction delay (first-degree atrioventricular conduction block) to life-threatening situations, such as a complete heart block. Although such manifestations occur late, our case report describes an interesting case where the patient developed a complete heart block in the setting of acute Lyme disease. An elevated IgM with negative IgG Lyme serology titer, an unusual finding, initially led us to face a diagnostic dilemma. Our suspicion of a tick bite was affirmed when we detected a positive titer for Babesia microti, an organism carried by the same tick and a common co-infection with Lyme disease. The patient improved with antibiotic therapy and temporary pacemaker support during the initial few days of admission.<\/jats:p>","DOI":"10.1093\/omcr\/omad089","type":"journal-article","created":{"date-parts":[[2023,9,27]],"date-time":"2023-09-27T19:03:43Z","timestamp":1695841423000},"source":"Crossref","is-referenced-by-count":4,"title":["A suspected case of Lyme disease causing complete heart block"],"prefix":"10.1093","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6613-6395","authenticated-orcid":false,"given":"Shahin","family":"Isha","sequence":"first","affiliation":[{"name":"Mayo Clinic Department of Critical Care Medicine, , Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Sharma","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Neurology and Neuro Critical Care, , Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel M","family":"Hannon","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Critical Care Medicine, , Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devang K","family":"Sanghavi","sequence":"additional","affiliation":[{"name":"Mayo Clinic Department of Critical Care Medicine, , Jacksonville, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,9,25]]},"reference":[{"key":"2023092719030098700_ref1"},{"key":"2023092719030098700_ref2","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.ijcard.2016.12.169","article-title":"Manifestations of Lyme carditis","volume":"232","author":"Kosti\u0107","year":"2017","journal-title":"Int J Cardiol"},{"key":"2023092719030098700_ref3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/j.cll.2010.01.003","article-title":"Lyme disease","volume":"30","author":"Murray","year":"2010","journal-title":"Clin Lab Med"},{"key":"2023092719030098700_ref4","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1086\/508667","article-title":"The clinical assessment, treatment, and prevention of Lyme disease, human granulocytic Anaplasmosis, and Babesiosis: clinical practice guidelines by the Infectious Diseases Society of America","volume":"43","author":"Wormser","year":"2006","journal-title":"Clin Infect Dis"},{"key":"2023092719030098700_ref5","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1016\/j.amjmed.2018.02.032","article-title":"Lyme endocarditis","volume":"131","author":"Paim","year":"2018","journal-title":"Am J Med"},{"key":"2023092719030098700_ref6","volume":"6","journal-title":"Healthcare"},{"key":"2023092719030098700_ref7","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1056\/NEJM200107123450207","article-title":"Lyme disease","volume":"345","author":"Steere","year":"2001","journal-title":"N Engl J Med"},{"key":"2023092719030098700_ref8","doi-asserted-by":"crossref","first-page":"S1435","DOI":"10.1093\/clinids\/11.Supplement_6.S1435","article-title":"Lyme disease surveillance in the United States, 1983-1986","volume":"11","author":"Ciesielski","year":"1989","journal-title":"Rev Infect Dis"},{"key":"2023092719030098700_ref9","doi-asserted-by":"crossref","first-page":"e451","DOI":"10.1161\/CIRCULATIONAHA.112.101485","article-title":"Cardiology patient pages. 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