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Lyme Myositis: Muscle Invasion by Borrelia burgdorferi

Ernest Atlas, MD; Stuart N. Novak, MD; Paul H. Duray, MD; and Allen C. Steere, MD
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Grant Support: Partial support by grant AR-20358 from the US Public Health Service.

Requests for Reprints: Allen C. Steere, MD, New England Medical Center, Division of Rheumatology and Immunology, Box 406, 750 Washington Street, Boston, MA 02111.

Current Author Addresses: Dr. Atlas: Section of Infectious Diseases, Norwalk Hospital, Norwalk, CT 06851; and Yale University School of Medicine, New Haven, CT 06510.

Dr. Novack: Section of Rheumatology, Norwalk Hospital, Norwalk, CT 06851; and Yale University School of Medicine, New Haven, CT 06510.

Dr. Duray: Fox Chase Cancer Center, Philadelphia, PA 19111.

Dr. Steere: Department of Rheumatology, Tufts University School of Medicine, New England Medical Center, Boston, MA 02111.

Ann Intern Med. 1988;109(3):245-246. doi:10.7326/0003-4819-109-3-245
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This excerpt has been provided in the absence of an abstract.

Lyme disease, which is caused by the tick-borne spirochete Borrelia burgdorferi (1), is well known as a cause of arthritis (2). Patients may have other musculoskeletal symptoms in addition to synovitis. Early in the illness, they may have painful tendons, bursae, entheses, muscles, or bones (3). We report a case of a patient with Lyme disease in whom inflammatory myositis was the major feature. Muscle biopsy showed invasion by B. burgdorferi and a lymphoplasmacellular immune response.

A 53-year-old man from West Redding, Connecticut, developed pain bilaterally in the lower abdomen and a temperature of up to 38.5 °C on 1


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