1. Lyme arthritis in Western Europe: a multicentre retrospective study
- Author
-
Brigitte Degeilh, Xavier Guennic, Benoit Le Goff, Jean-David Albert, Clémence Corre, Guillaume Coiffier, Solène Patrat-Delon, Pierre Tattevin, Marine Ferreyra, Centre hospitalier Bretagne Atlantique (Morbihan) (CHBA), CHU Pontchaillou [Rennes], Centre hospitalier Rene Pleven de Dinan, Centre hospitalier universitaire de Nantes (CHU Nantes), CHU de Saint-Brieuc, ARN régulateurs bactériens et médecine (BRM), Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
- Subjects
Adult ,Male ,Microbiology (medical) ,medicine.medical_specialty ,[SDV]Life Sciences [q-bio] ,Lyme Arthritis ,Polymerase Chain Reaction ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Borreliella ,Borrelia burgdorferi Group ,Interquartile range ,Internal medicine ,Borrelia ,Synovial Fluid ,medicine ,Monoarthritis ,Humans ,Synovial fluid ,Serologic Tests ,Borrelia burgdorferi ,Lyme borreliosis ,Retrospective Studies ,030304 developmental biology ,030203 arthritis & rheumatology ,Doxycycline ,Lyme Disease ,0303 health sciences ,biology ,business.industry ,Lyme arthritis ,General Medicine ,Middle Aged ,Amoxicillin ,bacterial infections and mycoses ,medicine.disease ,biology.organism_classification ,Antibodies, Bacterial ,Anti-Bacterial Agents ,3. Good health ,Europe ,Infectious Diseases ,business ,medicine.drug - Abstract
International audience; To characterize Lyme arthritis, with a focus on management, and outcome. Observational retrospective multicentre study in Western France, of all consecutive cases of Lyme arthritis, documented by Borrelia burgdorferi IgG on ELISA serological testing, confirmed by Western blot, with or without positive Borrelia PCR in synovial fluid, with no alternative diagnosis. We enrolled 52 patients (29 males), with a mean age of 43 +/- 19.4 years. Most patients had monoarthritis (n = 43, 82.7%), involving the knee (n = 51, 98.1%), with a median delay between symptoms onset and Lyme arthritis diagnosis of 5 months (interquartile range, 1.5-8). Synovial fluid analysis yielded median white cell count of 16,000/mm(3) (9230-40,500), and positive PCR in 16 cases (39%), for B. burgdorferi sensu stricto (n = 5), B. garinii (n = 5), B. afzelii (n = 3), and undetermined (n = 3). All patients received antibiotics, for a median duration of 28 days (21-30), with doxycycline (n = 44, 84.6%), ceftriaxone (n = 6, 11.5%), or amoxicillin (n = 2). Twelve patients (23.1%) also received intra-articular injection of glucocorticoids as first-line treatment. Of 47 patients with follow-up, 35 (74.5%) had complete resolution of Lyme arthritis. Lyme arthritis in Western Europe may be due to B. burgdorferi ss, B. afzelii, or B. garinii. Clinical presentation is similar to Lyme arthritis in North America (i.e. chronic knee monoarthritis), with low sensitivity of synovial fluid PCR (39%).
- Published
- 2021