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Lyme Disease and Arthritis

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Infections and the Rheumatic Diseases

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Abstract

Lyme disease is endemic in the northeastern United States and is caused by Borrelia burgdorferi, a pathogenic spirochete transmitted by the bite of an infected Ixodes ricinus complex tick. The three clinical phases of Lyme borreliosis are early-localized disease, early-disseminated disease, and late disease. Typical symptoms include erythema migrans during the early-localized phase, migratory inflammatory arthritis during the early-disseminated phase, and mono- or oligoarticular arthritis as the predominate presentation of late disease. Definitive diagnosis can be made based on erythema migrans (EM) lesions or a two-tier diagnostic approach that includes initial enzyme-linked immunosorbent assay followed by a Western blot analysis. Personal protection strategies and environmental interventions can be effective in preventing disease. However, if infection occurs, the Infectious Diseases Society of America recommends antibiotic treatment. The majority of treated patients will achieve resolution of symptoms within 20 days; however, Lyme arthritis may need an additional and prolonged course of antibiotic treatment. This chapter reviews the microbiology, spectrum of clinical presentation, diagnostic challenges, and therapeutic options of Lyme disease with a focus on Lyme arthritis.

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Authors and Affiliations

  1. Rheumatology, Rhode Island Hospital/Brown University, Providence, RI, USA

    Zuhal Arzomand

  2. Rheumatology, Roger Williams Medical Center, Providence, RI, USA

    Matthew White

  3. Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, RI, USA

    Anthony M. Reginato

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  1. Zuhal Arzomand
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  1. LSU Health Sciences at New Orleans, Louisiana State University, New Orleans, LA, USA

    Luis R. Espinoza

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Arzomand, Z., White, M., Reginato, A.M. (2019). Lyme Disease and Arthritis. In: Espinoza, L. (eds) Infections and the Rheumatic Diseases. Springer, Cham. https://doi.org/10.1007/978-3-030-23311-2_26

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