Abstract
Background:
Lyme carditis is a cardiovascular complication of early disseminated Lyme disease. Although guidelines recommend treatment with ceftriaxone followed by doxycycline, limited data support this recommendation.
Objective:
The purpose was to describe treatment strategies and outcomes of hospitalized patients treated for Lyme carditis.
Methods:
An institutional review board-approved, retrospective descriptive study was conducted within a large hospital network in an endemic region. Adults admitted with Lyme carditis were included. Outpatients, patients from external hospitals, or those without treatment were excluded. Electronic health record review was performed. The primary outcome was 30-day readmission; secondary outcomes included antibiotic days of therapy (DOT), length of stay (LOS), cardiac pacing, degree of heart block, PR interval reduction, and 30- or 90-day mortality. Data were analyzed using descriptive statistics.
Results:
Sixty-two patients (80.6% male, 93.5% white, median 47 years) were included with a median 4-day LOS; 28 (45.2%) had an intensive care unit admission. Fourteen (22.6%) received ceftriaxone alone for a median 28 DOT; 41 (66.6%) received a median 5 DOT ceftriaxone followed by 20 DOT doxycycline. Fifty-seven (91.9%) experienced heart block, 18 (29.0%) required temporary pacing, and 10 (16.1%) required a permanent pacemaker. A 7.3% reduction in median PR interval was observed from presentation to discharge. Three (4.8%) patients experienced Lyme carditis-related 30-day readmission. No mortality was observed.
Conclusions and relevance:
Readmission among patients treated for Lyme carditis was low across antibiotic regimens. This represents one of the largest analyses to evaluate Lyme carditis treatment and outcomes for hospitalized patients, helping clinicians better understand expected outcomes and management timelines.
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