Why I’m furious over observation status
A 37-year-old man was diagnosed with Lyme carditis after presenting to the emergency department (ED) with fever, weakness, history of tick bite, and prolonged PR interval of 394 ms (a type of heart block) and positive Lyme testing. In the ED, second-degree AV block was noted intermittently on the monitor but not documented. Both infectious disease and cardiology were consulted, and the recommendation was to continue IV ceftriaxone for 28 …