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Lyme Disease: Infectious and Noninfectious Features

  • Arthur Weinstein
Chapter

Abstract

Lyme disease (LD) is one of the most frequently diagnosed tick-borne bacterial diseases worldwide. It is caused by species within the Borrelia genus, spread by the Ixodes ticks. The initial sign of the disease is a ring-shaped rash with occasional central clearing, called erythema migrans (EM). If untreated, LD can result in early disseminated manifestations including generalized EM, carditis and central nervous system involvement, and late manifestations, including arthritis. LD generally responds well to a short course of antibiotics. However, about 10–15% of patients with Lyme arthritis fail the initial course of antibiotics, and some of those develop a chronic inflammatory arthritis optimally treated with local or systemic immunosuppressive agents. This is likely to be an autoimmune process, and these patients have similar human leukocyte antigen types as observed in patients with rheumatoid arthritis. Lessons learned from this illness may help us better understand the pathophysiology of postinfectious and possibly other forms of idiopathic arthritis as well.

Keywords

Borrelia burgdorferi Lyme arthritis Lyme disease Lyme neuroborreliosis 

Abbreviations

CDC

US Centers for Disease Control and Prevention

ELISA

Enzyme-linked immunosorbent assay

EM

Erythema migrans

HLA

Human leukocyte antigen

JIA

Juvenile idiopathic arthritis

LA

Lyme arthritis

LD

Lyme disease

LN

Lyme neuroborreliosis

PCR

Polymerase chain reaction

RA

Rheumatoid arthritis

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Clinical Professor Emeritus of MedicineGeorgetown UniversityWashington, DCUSA

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