The three deaths were investigated by CT, MA, NH, and NY Public Health Departments, as well as the CDC. Donated corneas from two decedents had been transplanted to three recipients before the diagnosis of Lyme disease was established, but no evidence of disease transmission was found.
Death from Lyme carditis is extremely rare, however it should be considered in events of sudden cardiac death in patients from high-incidence Lyme regions.
|Typical presentation of bull's eye rash associated with Lyme disease|
The detailed case reports of each of the three patients is available via the MMWR here. Briefly, it was found that two of the three patients had minor underlying heart conditions (hypertension, atherosclerosis, and Wolff-Parkinson-White syndrome which is a cardiac conduction abnormality) and did not present with the traditional bull's eye rash.
Two of the patients were found responsive, unfortunately the third patient had seen a physician one day prior to death and was prescribed clonazepam for anxiety (no EKG was performed, no antibiotics were prescribed).
Pathologically when observing Lyme associated carditis, diffuse, mixed, perivascular lymphoplasmacytic (primarily lymphocytes and plasma cells) infiltrates will be observed on examination of heart tissue. Immunohistochemistry, PCR, Warthin-Starry stain, Enzyme Immuno Assay, or and Western blot for bands at (23, 41, 58, and 66 kDa).
|Adult deer tick - Ixodes scapularis|
Lance D. Presser has a PhD in Microbiology and Immunology and currently is a Public Health Laboratorian
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