Complete antrioventricular block due to Lyme reinfection in a six year-old boy.

MEDICINE & HEALTH/RHODE ISLAND Lyme borreliosis results from infection by the spirochete Borrelia burgdorferi. The ixodes scapularis tick, commonly known as the deer tick, acts as a vector and is endemic in coastal New England and the Mid-Atlantic States. The disease is divided into early (after 3-32 days incubation) and late stages, as well as limited and disseminated disease. Limited disease is manifest by erythema migrans, whereas disseminated disease may have cardiac and neurologic involvement.1 Common presenting symptoms in children include fever, headache, erythema migrans (15% of cases), arthritis, arthralgia, myalgia, cranial nerve palsies, and meningitis. Carditis is present in only 0.5% of children.2 We present the case of a six-year-old boy with early disseminated Lyme disease manifesting as complete atrioventricular (AV) block after presentation to the emergency department for a complaint of abdominal pain.