Manifestations articulaires de la maladie de Lyme

Abstract

Lyme Borreliosis is a polyvisceral infectious disease due to Borrelia burgdorferi sensu lato transmitted by tick bite. Although the disease can evolve through different stages with mainly dermatological and neurological attacks, the typical clinical picture is that of monoarthritis of the knee. It is not always preceded by earlier stages such as erythema migrans. Its diagnosis is based on a combination of amnestic, clinical and biological criteria. Elisa and Western blot serology are always positive for Ig G. Treatment is based on antibiotic therapy for 28 days with doxycycline 200 mg/d. The evolution is generally favourable with in the majority of cases a restitution ad integrum. Polyalgesic syndromes with positive Lyme serology and a history of confirmed or suspected Lyme borreliosis must be treated with particular care, and diagnostic approach must be rigorous in order not to overlook differentials diagnosis which are many. Repeated antibiotic treatment does not improve these clinical pictures.