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Case report
Lyme aortitis
  1. Rita Reis Correia,
  2. Fábia Cruz,
  3. Sandra Martin and
  4. Maria Eugenia André
  1. Internal Medicine Department, Unidade Local de Saude de Castelo Branco EPE, Castelo Branco, Portugal
  1. Correspondence to Dr Rita Reis Correia; rt_correia{at}


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.

  • infections
  • cardiovascular system

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  • Contributors RRC, FC and SM observed the patient in the hospital and participated in all stages of diagnosis and follow-up. MEA discussed the clinical case as well as contributed to the elaboration and review of the article. All authors approved the final published version.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.