Open AccessLyme aortitis
Author(s) -
Rita Reis Correia,
Fábia Cruz,
Sarah E. Martin,
María Claudia André
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-231957
Subject(s) - medicine , aortitis , ascending aorta , asymptomatic , aortic dissection , lyme , giant cell arteritis , thoracic aorta , cardiology , descending aorta , chest pain , vasculitis , surgery , bicuspid aortic valve , lyme disease , aorta , acute aortic syndrome , borrelia burgdorferi , disease , virology , antibody , immunology
A 72-year-old man was admitted with complaints of sudden-onset oppressive precordial pain radiating to the back for 1 hour. He had hypotension, peripheral cyanosis and cold extremities. An initial assessment was done and acute coronary syndrome was excluded. After the patient was admitted, he developed fever and increased levels of inflammatory markers. Data obtained from CT angiography and transoesophageal echocardiogram revealed diffuse parietal thickening of the arch and the descending thoracic aorta, as well as dilatation of the aortic root and the proximal ascending aorta. In addition, the test for Borrelia burgdorferi was positive, and the patient was diagnosed with Lyme vasculitis of the thoracic aorta. He was treated with doxycycline for 3 weeks. Two months later, the patient exhibited a Stanford type A aortic dissection (clinically stable), which was treated by prosthesis replacement. The patient has remained asymptomatic for 1 year after the episode, performing his routine daily activities.