DOES CHLAMYDIA-TRACHOMATIS INFLUENCE MANIFESTATIONS OF LYME ARTHRITIS

Lyme arthritis, caused by the tick-borne spirochete Borrelia burgdorfe ri, produces typically intermittent episodes of arthritis of the large r joints, usually the knee joints. A number of patients, however, deve lop arthritis more closely resembling Reiter's syndrome, i.e., heel an d ankle involvement. We studied the clinical features of ten patients who developed arthritis after a tick bite and who had shown erythema m igrans and related it to the presence of evidence of Chlamydia trachom atis infection. Along with typical signs of Lyme arthritis we observed heel and ankle involvement. Chlamydia trachomatis was found in smears in 4 cases, whereas no patient had antichlamydial antibodies. However , evidence of Chlamydia trachomatis did not correlate with signs consi dered typical of Reiter's syn drome. Therefore, Lyme arthritis may hav e some arthritic manifestations resembling Reiter's syndrome, but this seems unrelated to the presence of Chlamydia trachomatis. Moreover, t he arthritis is not associated with HLA-B27.