Nat Rev Rheumatol. 2010 Dec 21; [Epub ahead of print]
A case revealing the natural history of untreated Lyme disease.
Schoen RT.
Section of Rheumatology, Yale University School of Medicine, Suite 6A, 60
Temple Street, New Haven, CT 06510, USA. robert.schoen@yale.edu.
Background A 71-year-old woman presented to a rheumatologist with what she
believed to be a 2-year history of Lyme disease, progressing from erythema
migrans to Lyme arthritis.Investigations History, physical examination and
serologic testing confirmed the diagnosis of Lyme disease.Diagnosis Lyme
disease.Management The patient refused antibiotic therapy during the first
2
years of her illness. During the next 2 years, she consulted a
rheumatologist, but declined antibiotic therapy. She continued to have
recurrent episodes of arthritis, following which she was successfully
treated with doxycycline, given initially for 2 weeks, with a second,
4-week
cycle administered 2 months later.
This case illustrates the natural history of untreated Lyme disease, which
is rarely observed in most patients since diagnosis almost always leads to
successful antibiotic treatment. Furthermore, this case also demonstrates
that infection with Borrelia burgdorferi can persist for years in untreated
patients; however, antibiotic therapy is still likely to be effective,
despite long-term infection.
http://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=211
73795&retmode=ref&cmd=prlinks
PMID: 21173795 [PubMed - as supplied by publisher]
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