Duration of Antibiotic Therapy for Lyme Disease
Authors: Allen C. Steere
Journal: Annals of Internal Medicine (2004)

Letters17 February 2004Duration of Antibiotic Therapy for Lyme DiseaseAllen C. Steere, MDAllen C. Steere, MDFrom Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-4-200402170-00027-w2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Stricker and McNeil quote my editorial incorrectly. It is important to distinguish chronic Lyme arthritis, in which a knee remains inflamed for months or several years despite antibiotic therapy, from chronic post–Lyme disease syndrome or so-called chronic Lyme disease, in which patients develop musculoskeletal, neurocognitive, or fatigue symptoms (similar to chronic fatigue syndrome or fibromyalgia) during or soon after Lyme disease despite standard antibiotic treatment for Borrelia burgdorferi infection.We have postulated that genetically susceptible patients with B. burgdorferi–infected knees may develop autoimmunity within the proinflammatory milieu of the joint because of molecular mimicry between an immunodominant ...References1. Gross DM, Forsthuber T, Tary-Lehmann M, Etling C, Ito K, Nagy ZA, et al . Identification of LFA-1 as a candidate autoantigen in treatment-resistant Lyme arthritis. Science. 1998;281:703-6. [PMID: 9685265] CrossrefMedlineGoogle Scholar2. Steere AC, Falk B, Drouin EE, Baxter-Lowe LA, Hammer J, Nepom GT. Binding of outer surface protein A and human lymphocyte function-associated antigen 1 peptides to HLA-DR molecules associated with antibiotic treatment-resistant Lyme arthritis. Arthritis Rheum. 2003;48:534-40. [PMID: 12571864] CrossrefMedlineGoogle Scholar3. Duray PH, Steere AC. Clinical pathologic correlations of Lyme disease by stage. Ann N Y Acad Sci. 1988;539:65-79. [PMID: 2847622] CrossrefMedlineGoogle Scholar4. Bockenstedt LK, Mao J, Hodzic E, Barthold SW, Fish D. Detection of attenuated, noninfectious spirochetes in Borrelia burgdorferi-infected mice after antibiotic treatment. J Infect Dis. 2002;186:1430-7. [PMID: 12404158] CrossrefMedlineGoogle Scholar5. Klempner MS, Hu LT, Evans J, Schmid CH, Johnson GM, Trevino RP, et al . Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease. N Engl J Med. 2001;345:85-92. [PMID: 11450676] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDuration of Antibiotic Therapy for Lyme Disease Allen C. Steere Duration of Antibiotic Therapy for Lyme Disease Raphael B. Stricker and Edward L. McNeil Metrics 17 February 2004Volume 140, Issue 4Page: W-7KeywordsAntibioticsAutoimmunityChronic fatigue syndromeFibromyalgiaKneesLyme diseaseProteinsSpirochetesTicksTissue cultures ePublished: 17 February 2004 Issue Published: 17 February 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...