SUDECKS ATROPHY IN LYME BORRELIOSIS

A patient with disseminated Lyme borreliosis is reported. The patient suffered from erythema migrans and radicular pain. Serologic tests rou tinely performed (IFT, ELISA, Western blots,vith different strains and Borrelia-LTT) were negative. However, Borrelia burgdorferi (genotype Borrelia afzelii) was cultivated from a skin biopsy. Western blot with the patient's isolate and sera showed strong reactivity only with the 60 kDa protein. In spite of immediate diagnosis and intravenous antib iotic treatment according to current recommendations he developed pain in the right ankle, which was resistant to further antibiotic and ant i-inflammatory therapy, Sudeck's atrophy was diagnosed by X-ray. Treat ment,vith calcitonin brought immediate relief from pain and led to rad iographically demonstrable recalcification.