Review Article
Volume 8 Issue 4 - 2021
Lyme Carditis: A Rare but Lethal Condition (A Practical Review of Lyme Disease: Past, Present, and Future)
Nicholas A Kerna1,2 *, ND Victor Carsrud3, Silile Ndhlovu4, Kevin D Pruitt5, Kyle Kadivi6, Yadira Pacheco Gutierrez7, Lawrence U Akabike8, Emmanuella Olubumni Solomon9 and Uzoamaka Nwokorie10
1SMC–Medical Research, Thailand
2First InterHealth Group, Thailand
3Lakeline Wellness Center, USA
4MyPainDoc PC, USA
5Kemet Medical Consultants, USA
6Global Health Group LLC, USA
7Universidad de Ciencias Medicas,Matanzas, Cuba
8Larrico Enterprises, LLC, USA
9Obafemi Awolowo University, Nigeria
10University of Washington, USA
*Corresponding Author: Nicholas A Kerna, (mailing address) POB47 Phatphong, Suriwongse Road, Bangkok, Thailand 10500. Contact:
Received: March 09, 2021; Published: March 29, 2021


Lyme disease was first identified in the late 1970s, by a consortium of scientists investigating individuals residing in Old Lyme, Connecticut (in the Northeastern U.S.) who experienced symptoms of unknown origin. The scientists from Yale School of Medicine and the Connecticut State Department of Health discovered that a tick bite caused the patients’ symptoms. It was later determined that the causative pathogen was Borrelia. The disease is endemic in the northern hemispheres with infection rates spiking in the warmer and summer months.

In 70–80% of infected individuals, the disease is characterized by the hallmark (painless) erythema migrans (EM) rash or lesion, occurring about 3–30 days post-tick bite. In the early stages after infection, symptoms may include myalgia, arthralgia, regional lymphadenopathy, headache, and fever. Symptoms may progress to secondary skin lesions, malaise, headache, neck stiffness, chills, and arthralgia. If left untreated, neurological and cardiac-related complications can occur (such as meningitis, subtle encephalitis, cranial neuritis, neuropathy, ataxia, myelitis, presyncope, syncope, dyspnea, arrhythmia or angina, accompanied by pyrexia and myalgia). Lyme carditis, although rare, can be fatal. Also, specific psychological symptoms and disorders can be aggravated or provoked by Lyme disease.

To combat the Borrelia pathogen, specific oral or intravenous (IV) antibiotics are prescribed. Most Lyme disease cases respond favorably with a 10–28 days course of antibiotics. However, in 10–20% of the treated cases, post-treatment Lyme disease syndrome (PTLDS) develops—the etiology and treatment of which is currently undecided.

The most effective prevention against Lyme disease is avoiding a tick-bite, and wearing appropriate clothing, using anti-tick sprays, and performing a body inspection, preferably with a mirror. Novel treatment regimes—as yet not medically-recognized or endorsed—consist of herbal remedies and herbal-drug combinations. There is no vaccine against the disease, although research into a universal vaccine continues.


Keywords: Deer; Fever; Malaise; Outdoors; Rash; Tick


  1. Stone BL., et al. “Brave New Worlds: The Expanding Universe of Lyme Disease”. Vector-Borne and Zoonotic Diseases 17 (2017): 619-629.
  2. Elbaum-Garfinkle S. “Close to home: A history of Yale and Lyme disease”. Yale Journal of Biology and Medicine 84 (2011): 103-108.
  3. Steere AC., et al. “Erythema chronicum migrans and Lyme arthritis: Epidemiologic evidence for a tick vector1”. American Journal of Epidemiology 4 (1978): 312-321.
  4. Pachner AR and Steere AC. “Neurological findings of Lyme disease”. Yale Journal of Biology and Medicine 4 (1984): 481-483.
  5. Steere AC., et al. “Neurologic abnormalities of Lyme disease: Successful treatment with high-dose intravenous penicillin”. Annals of Internal Medicine6 (1983): 281-294.
  6. Steere AC., et al. “Lyme carditis: Cardiac abnormalities of Lyme disease”. Annals of Internal Medicine11 (1980): 8-16.
  7. Malawista SE., et al. “Lyme disease: A unique human model for an infectious etiology of rheumatic disease”. Yale Journal of Biology and Medicine4 (1984): 473-477.
  8. Hardin JA., et al. “Immune Complexes and the Evolution of Lyme Arthritis: Dissemination and Localization of Abnormal C1q Binding Activity”. The New England Journal of Medicine25 (1979): 1358-1363.
  9. Hardin JA., et al. “Circulating Immune Complexes in Lyme Arthritis”. Journal of Clinical Investigation3 (1979): 468-477.
  10. Burgdorfer W., et al. “Lyme disease - A tick-borne spirochetosis?” Science4552 (1982): 1317-1319.
  11. Johnson RC., et al. “Borrelia burgdorferi sp. nov.: Etiologic agent of Lyme disease”. International Journal of Systematic Bacteriology4 (1984): 496-497.
  12. Barbour AG and Benach JL. “Discovery of the Lyme disease agent”. mBio5 (2019): e02166-02119.
  13. Lyme Disease (2021).
  14. Government of Canada. Surveillance of Lyme Disease (2021).
  15. Dolgin E. “Climate change: As the ice melts”. Nature7647 (2017): S54-55.
  16. Grochowska A., et al. “Comparison of tick-borne pathogen prevalence in Ixodes ricinus ticks collected in urban areas of Europe”. Scientific Reports 1 (2020).
  17. Fang LQ., et al. “Emerging tick-borne infections in mainland China: An increasing public health threat”. The Lancet Infectious Diseases 15 (2015): 1467-1479.
  18. Von Fricken ME., et al. “Geographic Range of Lyme Borreliosis in Mongolia”. Vector-Borne and Zoonotic Diseases 9 (2019): 658-661.
  19. Sabitova Y., et al. “Multilocus sequence analysis of Borrelia burgdorferi sensu lato isolates from Western Siberia, Russia and Northern Mongolia”. Infection, Genetics and Evolution 62 (2018): 160-169.
  20. Lee W., et al. “A comparative study of the trends in epidemiological aspects of Lyme disease infections in Korea and Japan, 2011-2016”. Journal of Vector Borne Diseases3 (2019): 268-271.
  21. Dedkov VG., et al. “The burden of tick-borne diseases in the Altai region of Russia”. Ticks and Tick-borne Diseases5 (2017): 787-794.
  22. Pun SB., et al. “First report of Lyme disease in Nepal”. JMM Case Reports3 (2018): e005128.
  23. Tevatia P., et al. “Lyme disease in north India: a case for concern”. Tropical Doctor4 (2018): 352-355.
  24. Shapiro ED. “Borrelia burgdorferi (Lyme Disease)”. Pediatrics in Review12 (2014): 500-509.
  25. Rudenko N., et al. “Updates on borrelia burgdorferi sensu lato complex with respect to public health”. Ticks and Tick-borne Diseases 2 (2011): 123-128.
  26. Tatum R, Pearson-Shaver AL. Borrelia Burgdorferi. [Updated 2020 Jul 19]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from:
  27. Lantos PM., et al. “Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease”. Clinical Infectious Diseases 1 (2020): e1-48.
  28. Bransfield R. “Neuropsychiatric Lyme Borreliosis: An Overview with a Focus on a Specialty Psychiatrist’s Clinical Practice”. Healthcare3 (2018): 104
  29. National Institute of Allergy and Infectious Diseases (NIAID)”. Current Efforts in Lyme Disease Research (2019).
  30. Molins CR., et al. “Development of a metabolic biosignature for detection of early Lyme disease”. Clinical Infectious Diseases12 (2015): 1767-1775.
  31. Bhatia B., et al. “Infection history of the blood-meal host dictates pathogenic potential of the Lyme disease spirochete within the feeding tick vector”. PLoS Pathogens4 (2018): e1006959.
  32. Seiler KP and Weis JJ. “Immunity to Lyme disease: protection, pathology and persistence”. Current Opinion in Immunology4 (1996): 503-509.
  33. Shen AK., et al. “The lyme disease vaccine-A public health perspective”. Clinical Infectious Diseases3 (2011): 247-252.
  34. Pothineni VR., et al. “Azlocillin can be the potential drug candidate against drug-tolerant Borrelia burgdorferi sensu stricto JLB31”. Scientific Reports1 (2020): 3798.
  35. Uhde M., et al. “C-Reactive Protein Response in Patients With Post-Treatment Lyme Disease Symptoms Versus Those With Myalgic Encephalomyelitis/Chronic Fatigue Syndrome”. Clinical Infectious Diseases8 (2018): 1309-1310.
  36. Wormser GP., et al. “The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America”. Clinical Infectious Diseases9 (2006): 1089-1134.
  37. Bernardino Andrea L F., et al. “The Antibiotics Doxycycline and Minocycline Inhibit the Inflammatory Responses to the Lyme Disease SpirocheteBorrelia burgdorferi”. The Journal of Infectious Diseases9 (2009): 1379-1388.
  38. I Horowitz R and R Freeman P. “Efficacy of Double-Dose Dapsone Combination Therapy in the Treatment of Chronic Lyme Disease/Post-Treatment Lyme Disease Syndrome (PTLDS) and Associated Co-infections: A Report of Three Cases and Retrospective Chart Review”. Antibiotics11 (2020): 725.
Citation: Kerna NA, Carsrud NDV, Ndhlovu S, Pruitt KD, Kadivi K, Gutierrez YP, Akabike LU, Solomon EO, Nwokorie U. “Lyme Carditis: A Rare but Lethal Condition (A Practical Review of Lyme Disease: Past, Present, and Future)”. EC Gynaecology 8.4 (2021): 32-42.

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