Lyme arthritis: clinical features, serological, and radiographic findings of cases in Germany

The clinical manifestations, serological data, and radiographic findings of ten cases of Lyme arthritis in Germany are summarized. Qualitative assessment shows that the characteristics of the disease in Germany do not differ fundamentally from those reported in the USA. However, since a serological test for antibodies to the causative spirochete is now available, the great variety of the clinical features of Lyme arthritis can be described more precisely. The cases of chronic Lyme arthritis without prior erythema chronicum migrans, hitherto the most important diagnostic hallmark of the disease, may have been underestimated. One of the cases reported provides evidence that the disease was transmitted via a fly bite. Radiographic abnormalities consisting of marked juxta-articular osteoporosis and osseous erosions were found in two patients with chronic arthritis. Three patients were treated with high-dose intravenous penicillin, two did not respond to the therapy.