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  lüll Range of atrioventricular conduction disturbances in Lyme borreliosis: a report  of four cases and review of other published reports van der Linde MR; Crijns HJ; de Koning J; Hoogkamp-Korstanje JA; de Graaf JJ; Piers DA; van der Galien A; Lie KIBr Heart J  1990[Mar]; 63 (3): 162-8Four patients with Lyme borreliosis had atrioventricular conduction disturbances.  All four were positive for specific antibodies against Borrelia burgdorferi  measured by indirect immunofluorescence tests. Biopsy specimens, which were  obtained in three patients, showed band-like infiltrates of plasma cells and  lymphocytes in the endocardium. There was diffuse infiltration of the  interstitium of the myocardium by lymphocytes, plasma cells, and macrophages. In  two patients single fibre necrosis was seen in the myocardium. Biopsy specimens  of the heart showed spirochetes in all three patients and serial sections stained  by the Bosma-Steiner technique showed that they resembled Borrelia burgdorferi.  At follow up one patient had persistent complete atrioventricular block, despite  treatment with antibiotics and corticosteroid, and a permanent pacemaker was  implanted.|Adult[MESH]|Antibodies, Bacterial/analysis[MESH]|Atrioventricular Node/*physiopathology[MESH]|Borrelia burgdorferi Group/immunology[MESH]|Electrocardiography[MESH]|Female[MESH]|Heart Block/*etiology/physiopathology/therapy[MESH]|Heart Conduction System/*physiopathology[MESH]|Humans[MESH]|Immunoglobulin G/analysis[MESH]|Immunoglobulin M/analysis[MESH]|Lyme Disease/*complications/immunology/pathology[MESH]|Male[MESH]|Myocardium/pathology[MESH]|Pacemaker, Artificial[MESH] |