post Lyme disease syndrome

Etiology

• association with Lyme disease, but cause-effect not proven

Pathology

• a peptidoglycan in the cell envelope of Borrelia burgdorferi is released but not degraded when the bacterium dies
  • the peptidoglycan lingers in synovial fluid & elicits an ongoing immune response*

* systemic administration of the peptidoglycan ellicits acute arthritis in mice

Clinical manifestations

• fatigue
• widespread musculoskeletal pain (myalgia, arthralgia)
• cognitive impairment

* symptom onset within 6 months of Lyme disease diagnosis, continuing for at least 6 months after antibiotic treatment

Differential diagnosis

• fibromyalgia
• chronic fatigue syndrome
  • unrefreshing sleep, post-exertional malaise, orthostatic intolerance

Management

• antibiotics not effective

More general terms

• syndrome

Additional terms

• Lyme disease