Signs and Symptoms of Stage - 3 (Late Persistent Infection) Months after the onset of infection about 60% of the individuals who have received no antibiotic treatment, develop frank arthritis. The typical pattern comprises of intermittent attacks of arthritis in large joints (especially the knees), lasting for weeks to months in a given joint. Small joints, and structures around them may also be affected, mainly during early attacks. The rate of recurrence reduces each year. However in a small percentage of cases, involvement of large joints - usually one or both knees - becomes chronic, and may lead to erosion of bone and cartilage. In such people, on analysis their joint fluid has a very high count of white blood cells (on an average, 25,000/micro liter) and antibodies to OspA and OspB protein (major outer surface protein of Borrelia), but lack Borrelia DNA in synovial fluid as detected by PCR. Tests for rheumatoid factor or anti nuclear antibody test for lupus erythematosus usually give negative results. Although less common, chronic nervous system involvement may become apparent months or years after the onset of infection, sometimes following long periods of latent infection. It begins as subtle changes in mood, memory, or sleep disturbances and progresses to tingling in the nerves or pain along particular spinal nerve segments. Acrodermatitis chronica atrophicans is a late skin manifestation associated with Borrelia afzelli infection in Europe and Asia. Seen mainly in elderly women, the lesion begins insidiously with reddish to violaceous discoloration on acral surfaces of arms and legs (on the front of forearms and legs) and gradually develop hardening and thinning of skin over a period of years. Lyme disease is caused by the spirochete Borrelia burgdorferi and transmitted by vectors of Ixodes species that carry the microbe in their intestines. It progresses in three phases, consisting of expanding skin lesions, cardiac and neurological disease, and progressing into arthritis and a chronic neurological syndrome.
Posted on: Tue, 11 Nov 2014 20:46:37 +0000
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