Lyme Arthritis

Infect Dis Clin North Am. 2022 Sep;36(3):563-577. doi: 10.1016/j.idc.2022.03.006.

Abstract

Arthritis is the most common late manifestation of Borrelia burgdorferi infection in the United States, usually beginning months after the tick bite. In most patients with Lyme arthritis (LA) today, arthritis is the presenting manifestation of the disease. Patients have swelling and pain in one or a few large joints, especially the knee. Serologic testing is the mainstay of diagnosis. Responses to antibiotic treatment are generally excellent, although a small percentage of patients have persistent, postinfectious synovitis after 2 to 3 months of oral and IV antibiotics, which respond to anti-inflammatory therapies. Herein we review the clinical presentation, diagnosis, and management of LA.

Keywords: Borrelia burgdorferi; Inflammatory arthritis; Lyme arthritis; Lyme disease; Postantibiotic arthritis; Postinfectious arthritis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Arthritis* / drug therapy
  • Humans
  • Lyme Disease* / complications
  • Lyme Disease* / diagnosis
  • Lyme Disease* / drug therapy

Substances

  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents