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Clinical Rheumatology

, Volume 21, Issue 4, pp 330–334 | Cite as

Seronegative Lyme Arthritis caused by Borrelia garinii

  • H. Dejmková
  • D. Hulínska
  • D. Tegzová
  • K. Pavelka
  • J. Gatterová
  • P. Vavřík
Case Report

Abstract

A case of a female patient suffering from Lyme arthritis (LA) without elevated antibody levels to Borrelia burgdorferi sensu lato is reported. Seronegative Lyme arthritis was diagnosed based on the classic clinical manifestations and DNA-detected Borrelia garinii in blood and synovial fluid of the patient, after all other possible causes of the disease had been ruled out. The disease was resistant to the first treatment with antibacterial agents. Six months after the therapy, arthritis still persisted and DNA of Borrelia garinii was repeatedly detected in the synovial fluid and the tissue of the patient. At the same time, antigens or parts of spirochaetes were detected by electron microscopy in the synovial fluid, the tissue and the blood of the patient. The patient was then repeatedly treated by antibiotics and synovectomy has been performed.

Key words:Borrelia garinii– Lyme arthritis – Therapeutic failure 

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Copyright information

© Clinical Rheumatology 2002

Authors and Affiliations

  • H. Dejmková
    • 1
  • D. Hulínska
    • 2
  • D. Tegzová
    • 1
  • K. Pavelka
    • 1
  • J. Gatterová
    • 1
  • P. Vavřík
    • 3
  1. 1.Institute of Rheumatology, PraguePrague
  2. 2.National Institute of Public Health, Reference Laboratory on Borreliosis and Electron Microscopy, PraguePrague
  3. 3.I Orthopaedic clinic, First Medical Faculty, Charles University, Prague, Czech RepublicPrague

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