11/22. Lyme arthritis presenting as adult onset Still's disease.lyme disease and adult onset Still's disease share several clinical characteristics such as fever, lymphosplenomegaly, skin involvement, and arthritis. borrelia burgdorferi has been recognized as the cause of lyme disease and an infectious agent has been suspected, at least as triggering factor, in adult onset Still's disease. This work is concerned with a patient affected by atypical lyme disease originally diagnosed as adult onset Still's disease. B. burgdorferi infection must be suspected in cases of arthritis suggestive of adult onset Still's disease.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
12/22. Late stage Lyme borreliosis in children.These cases illustrate that late stage Lyme borreliosis can occur in children without a history of tick bite or ECM; this disorder can manifest itself initially as a seventh cranial nerve palsy, heart block, or arthritis, and the arthritis syndrome can mimic oligoarticular juvenile rheumatoid arthritis. The diagnosis of Lyme borreliosis depends upon clinical recognition. In the absence of ECM, tests for antibodies to borrelia burgdorferi can provide an invaluable tool in assisting in the diagnosis. Children who live in or visit areas endemic for Lyme borreliosis and who have arthritis, heart block, or neurologic disorders such as facial palsy should be tested for antibodies to borrelia burgdorferi if no other cause for the disease syndrome is identified clinically.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
13/22. borrelia burgdorferi in joint fluid in chronic Lyme arthritis.Although indirect evidence suggests that chronic Lyme arthritis is caused by persistent infection with borrelia burgdorferi, direct visualization has been lacking. We report the demonstration of B. burgdorferi from synovial fluid aspirated from the right knee of a 31-year-old man with Lyme arthritis for more than 1 year. After 6 days, culture medium inoculated with synovial fluid showed one motile and several nonmotile spirochetes. Direct immunofluorescence staining showed reactivity with anti-B. burgdorferi serum. Spirochetes were not seen in subcultured material. The patient's arthritis improved with high-dose intravenous penicillin. Identification of B. burgdorferi from the joint fluid of a patient with long-standing arthritis supports the concept that the arthritis is due to persistent infection.- - - - - - - - - - ranking = 4keywords = burgdorferi (Clic here for more details about this article) |
14/22. Lyme pericarditis leading to tamponade.We report the case of a 62-yr-old man who presented with Lyme pericarditis leading to cardiac tamponade shortly followed by an arthritis. IgM and IgG antibodies to borrelia burgdorferi were demonstrated in serum by indirect immunofluorescence. borrelia burgdorferi was demonstrated and identified in pericardial fluid by indirect immunofluorescence using serum from a patient with proven lyme disease and by a monoclonal antibody immuno-gold silver stain. Spirochetes were also found in synovial biopsies using a silver stain. The tamponade was treated with pericardiocentesis; the arthritis was treated with intravenous ceftriaxone (2 g once daily) for 14 days. The patient recovered completely within days of commencing treatment. This case report demonstrates that borrelial infection may lead to pericarditis and cardiac tamponade.- - - - - - - - - - ranking = 1.2304616858748keywords = burgdorferi, borrelia (Clic here for more details about this article) |
15/22. Cellular hyperimmunoreactivity to rubella virus synthetic peptides in chronic rubella associated arthritis.OBJECTIVES--Immune recognition of the major structural proteins of rubella virus by peripheral blood mononuclear cells and synovial inflammatory infiltrates of a patient with documented chronic rubella associated arthritis was compared with responses of normal healthy rubella virus immunoreactive subjects to establish if there were unusual response patterns associated with rubella associated arthritis in this subject. methods--Synthetic peptides (16-33 amino acids in length) representing selected amino acid sequences of the rubella virus envelope (E1 and E2) and capsid (C) proteins were used in lymphocyte stimulation assays with peripheral blood mononuclear cells or synovial inflammatory infiltrates to determine T lymphocyte recognition of antigenic sites within the synthetic peptides. A rubella virus specific polymerase chain reaction was used to determine the persistence of rubella virus in the patient's cells. RESULTS--The patient's peripheral blood mononuclear cells showed abnormally increased lymphoproliferative responses to three E1 synthetic peptides encompassing residues 219-234, 389-411, and 462-481, and one E2 synthetic peptide containing the sequence 50-72, of which the last three were predicted to contain T cell antigenic sites. Although the patient's peripheral blood mononuclear cells showed positive proliferative responses to C synthetic peptides, these were not unusual. The number of synthetic peptides within the E1, E2, and C panels recognised by the patient's peripheral blood mononuclear cells was greater than was previously observed in normal healthy subjects. The recognition of synthetic peptides by synovial inflammatory infiltrates was similar to peripheral blood mononuclear cells but the responses measured were lower. The polymerase chain reaction was negative for rubella virus detection in peripheral blood mononuclear cells and synovial inflammatory infiltrates. CONCLUSIONS--Abnormally increased T cell recognition of antigenic sites within rubella virus E1 and E2 proteins observed in this patient with rubella associated arthritis suggests chronic antigenaemia due to persistent rubella virus in tissue sites other than peripheral blood mononuclear cells or synovial inflammatory infiltrates.- - - - - - - - - - ranking = 0.070439562398831keywords = lyme (Clic here for more details about this article) |
16/22. Chronic septic arthritis caused by borrelia burgdorferi.Chronic arthritis occurs in 10% of lyme disease patients. A patient had chronic septic Lyme arthritis of the knee for seven years despite multiple antibiotic trials and multiple arthroscopic and open synovectomies. Spirochetes were documented in synovium and synovial fluid (SF). polymerase chain reaction (PCR) analysis of the SF was consistent with Borrelia infection. Persistent infection should be excluded with silver stains and cultures in any patient with chronic monoarticular arthritis and a history of lyme disease.- - - - - - - - - - ranking = 2.0352197811994keywords = burgdorferi, lyme (Clic here for more details about this article) |
17/22. Acute arthritis of the hip in a child infected with the Lyme spirochete.Acute Lyme arthritis may mimic acute pyogenic arthritis. Although the arthritis associated with infection with the spirochete, borrelia burgdorferi, is more commonly seen in the chronic stage (Stage III) of the disease, occasionally it may present as the initial clinical manifestation. A five-year-old girl with acute arthritis of the hip is reported to discuss classification and management of arthritis associated with lyme disease.- - - - - - - - - - ranking = 0.5keywords = burgdorferi (Clic here for more details about this article) |
18/22. Repeated detection of borrelia burgdorferi dna in synovial fluid of a child with Lyme arthritis.In the pathogenesis of late Lyme borreliosis the relative importance of the causative organism, borrelia burgdorferi, and the immune response of the host, including autoimmune phenomena, is not yet known. We describe a 7-year-old boy with Lyme arthritis from whom two synovial fluid samples were obtained 5 months apart and up to 17 months after the first appearance of arthritis. Both synovial fluid specimens were shown to contain borrelial dna by nested polymerase chain reaction for the amplification of portions of the genes for flagellin and OspA. Thus, borrelia burgdorferi may persist within the joint even during late stages of the disease.- - - - - - - - - - ranking = 3.2656814670743keywords = burgdorferi, borrelia, lyme (Clic here for more details about this article) |
19/22. Lyme borreliosis in rheumatological practice: identification of Lyme arthritis and diagnostic aspects in a Swedish county with high endemicity.To prospectively study the prevalence of Lyme arthritis, 100 consecutive patients referred to a rheumatology out-patient clinic and 115 patients with a classified rheumatological disease were included. Individuals seropositive for antibody against the borrelia burgdorferi sensu lato complex were examined for clinical signs or a history of Lyme borreliosis. Positive titres against B. burgdorferi s.l. were found in 7/100 and 15/115, respectively. Among the 100 referred patients. Lyme arthritis was diagnosed in five cases. carpal tunnel syndrome was the presenting clinical feature in two of them. One of the 115 individuals with a previously classified rheumatological disease was re-classified as Lyme arthritis. All cases of Lyme arthritis improved after oral antibiotic treatment. This study revealed Lyme arthritis to be a common disorder in this part of sweden and the diagnosis should be considered in patients with acute or recurrent episodes of mono- or oligoarthritis.- - - - - - - - - - ranking = 1keywords = burgdorferi (Clic here for more details about this article) |
20/22. Persistence of staphylococcus aureus as detected by polymerase chain reaction in the synovial fluid of a patient with septic arthritis.Septic arthritis commonly occurs in the rheumatoid arthritis population. The diagnosis is frequently delayed and the associated mortality is high. In this brief report, we present a patient with rheumatoid arthritis and prosthetic knee joints who developed septic arthritis and had persisting evidence of staphylococcus aureus dna in synovial fluid, from his knees, which was detected by polymerase chain reaction (PCR) and a gene probe. This was detected until 10 weeks of therapy despite adequate antibiotic treatment and a sterile synovial fluid. In the future, it may be found that PCR of the synovial fluid will be a valuable investigation for the diagnosis and management of septic arthritis.- - - - - - - - - - ranking = 0.17609890599708keywords = lyme (Clic here for more details about this article) |
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