Lyme Disease and Arthritis

  • Zuhal Arzomand
  • Matthew White
  • Anthony M. Reginato


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.


Lyme disease Lyme arthritis ELISA Western blot assay Erythema migrans Lyme disease treatment Borrelia burgdorferi Infectious arthritis Doxycycline 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Zuhal Arzomand
    • 1
  • Matthew White
    • 2
  • Anthony M. Reginato
    • 3
  1. 1.RheumatologyRhode Island Hospital/Brown UniversityProvidenceUSA
  2. 2.RheumatologyRoger Williams Medical CenterProvidenceUSA
  3. 3.Division of RheumatologyThe Warren Alpert School of Medicine at Brown UniversityProvidenceUSA

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