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Detecting the Lyme Disease Spirochete, Borrelia Burgdorferi, in Ticks Using Nested PCR
Published on: February 4, 2018
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Trauma-related Lyme arthritis.
John Roberts1, Elisabeth Merchant2,3
1Tufts University School of Medicine, Boston, Massachusetts, USA john.roberts@tufts.edu.
BMJ Case Reports
|July 5, 2023
Summary
Traumatic knee injury may trigger Lyme arthritis. This case report details how a meniscal tear preceded Lyme arthritis, highlighting a potential link between joint trauma and latent Borrelia burgdorferi infection.
Area of Science:
- Infectious Diseases
- Orthopaedic Surgery
- Rheumatology
Background:
- Lyme arthritis is a common manifestation of late-stage Lyme disease, typically affecting large joints like the knee.
- While often associated with tick bites, the precise mechanisms triggering Lyme arthritis in predisposed individuals are not fully understood.
Observation:
- A middle-aged man with a traumatic meniscal tear developed acute knee pain, swelling, fever, and chills.
- Knee joint aspiration showed high white blood cell count, but negative Gram stain and culture.
- Positive Lyme PCR and serology confirmed Lyme arthritis.
Findings:
- The patient's Lyme arthritis resolved with antibiotic treatment.
- This is the first reported case of Lyme arthritis seemingly provoked by traumatic knee injury.
- The study proposes that joint trauma may facilitate the migration of Borrelia burgdorferi into synovial tissue, exacerbating inflammation.
Implications:
- Traumatic joint injuries could potentially unmask or exacerbate latent Lyme disease.
- Further research is warranted to explore the interaction between joint trauma and Borrelia burgdorferi infection.
- This case expands the understanding of Lyme arthritis's potential triggers and clinical presentations.
