PT  - JOURNAL ARTICLE
AU  - F-X Limbach
AU  - B Jaulhac
AU  - X Puechal
AU  - H Monteil
AU  - J-L Kuntz
AU  - Y Piemont
AU  - J Sibilia
TI  - Treatment resistant Lyme arthritis caused by<em>Borrelia garinii</em>
AID  - 10.1136/ard.60.3.284
DP  - 2001 Mar 01
TA  - Annals of the Rheumatic Diseases
PG  - 284--286
VI  - 60
IP  - 3
4099  - http://ard.bmj.com/content/60/3/284.short
4100  - http://ard.bmj.com/content/60/3/284.full
SO  - Ann Rheum Dis2001 Mar 01; 60
AB  - Lyme arthritis is caused in Europe by three main pathogenic species of Borrelia burgdorferi sensu lato:Borrelia burgdorferi sensu stricto,Borrelia garinii, andBorrelia afzelii. Because few synovial samples have yet been analysed by species-specific DNA amplification methods, further studies are needed to define the spectra of clinical manifestations associated with these different species. Two cases of treatment resistant Lyme arthritis are reported here, in which DNA amplification of the flagellin gene followed by dot-blot hybridisation in the synovial fluid identifiedB garinii as the causative agent. Clinical and biological data did not differ from the usual descriptions of Lyme arthritis, but as the recently reported molecular mimicry between OspA and hLFA1 is not applicable to B garinii, the pathogenesis of the present cases remains unclear. Future studies should aim at assessing the role of B garinii in European Lyme arthritis and its possible pathogenic and therapeutic consequences.