Advertisement

Therapy of Joint Manifestations

  • P. Herzer

Abstract

Antibiotic therapy is considered the mainstay of treatment for joint manifestations of Lyme borreliosis. However, many questions remain unanswered, and many difficulties hinder the approach to therapy; for example (a) Large-scale placebo-controlled treatment studies are lacking; (b) uncontrolled or comparative studies do not take spontaneous remissions into account; in the report by Steere et al. (1987) of 21 untreated patients with Lyme arthritis, the number of patients with attacks of arthritis decreased by 10%–20% each year; (c) criteria for judgement of treatment success or failure are defined arbitrarily and heterogenously; and (d) there are uncertainties in the diagnosis of Lyme arthritis and, in particular, as regards arthralgias due to borrelial infection.

Keywords

Lyme Disease Lyme Borreliosis Lyme Arthritis Intravenous Ceftriaxone Joint Manifestation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Coblyn JS, Taylor P (1981) Treatment of chronic Lyme arthritis with hydroxychloroquine. Arthritis Rheum 24:1567–1569PubMedCrossRefGoogle Scholar
  2. Dattwyler RJ, Volkman DJ, Halperin JJ, Luft BJ (1988) Treatment of late Lyme borreliosis — randomized comparison of ceftriaxone and penicillin. Lancet 1:1191–1194PubMedCrossRefGoogle Scholar
  3. Hassler D, Zöller L, Haude M, Hufnagel H-D, Heinrich F, Sonntag H-G (1990) Cefotaxime versus penicillin in the late stage of Lyme disease — prospective, randomized therapeutic study. Infection 18:16–20PubMedCrossRefGoogle Scholar
  4. Herzer P (1988) Antibiotische Therapie der Lyme-Arthritis. Klin Wochenschr 66 (Suppl XIII):119Google Scholar
  5. Herzer P (1989) Lyme-Borreliose. Epidemiologie, Ätiologie, Diagnostik, Klinik und Therapie. Steinkopff, Darmstadt, GermanyGoogle Scholar
  6. Herzer P, Wilske B, Preac-Mursic V, Schierz G, Schattenkirchner M, Zöllner N (1986) Lyme arthritis: clinical features, serological, and radiographic findings of cases in Germany. Klin Wochenschr 64:206–215PubMedCrossRefGoogle Scholar
  7. Huaux JP, Bigaignon G, Stadtsbaeder S, Zangerle PF, Nagant de Deuxchaisnes C (1988) Pattern of Lyme arthritis in Europe: report of 14 cases. Ann Rheum Dis 47:164–165PubMedCrossRefGoogle Scholar
  8. Liu NY, Dinerman H, Levin RE, Massarotti E, Molloy PJ, Schoen RT, Taylor E, Steere AC (1989) Randomized trial of doxycycline vs. amoxicillin/probenecid for the treatment of Lyme arthritis: treatment of non-responders with i. v. penicillin or ceftriaxone. Arthritis Rheum (Suppl) 32:S46Google Scholar
  9. McLaughlin TP, Zemel L, Fisher RL, Gossling HR (1986) Chronic arthritis of the knee in Lyme disease. Review of the literature and report of two cases treated by synovectomy. J Bone Joint Surg 68A: 1057–1060Google Scholar
  10. Schaad UB, Flüeler U, Schaub H, Suter H, Vischer D, Caflisch U, Tschumi A, Wick H, Vest M, Durrer D (1986) DurchIxodes-ricinus-Spirochäten (Borrelia burgdorferi) verursachte Krankheitsbilder (Lyme-Krankheit) bei pädiatrischen Patienten in der Schweiz. Schweiz Med Wochenschr 116:1426–1430PubMedGoogle Scholar
  11. Steere AC, Green J, Schoen RT, Taylor E, Hutchinson GJ, Rahn DW, Malawista SE (1985) Successful parenteral penicillin therapy of established Lyme arthritis. N Engl J Med 312:869–874PubMedCrossRefGoogle Scholar
  12. Steere AC, Schoen RT, Taylor E (1987) The clinical evolution of Lyme arthritis. Ann Intern Med 107:725–731PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1993

Authors and Affiliations

  • P. Herzer

There are no affiliations available

Personalised recommendations