CHRONIC SEPTIC ARTHRITIS CAUSED BY BORRELIA-BURGDORFERI

Chronic arthritis occurs in 10% of Lyme disease patients. A patient ha d chronic septic Lyme arthritis of the knee for seven years despite mu ltiple antibiotic trials and multiple arthroscopic and open synovectom ies. 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 silv er stains and cultures in any patient with chronic monoarticular arthr itis and a history of Lyme disease.