{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T07:27:04Z","timestamp":1778657224250,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2005,11,29]],"date-time":"2005-11-29T00:00:00Z","timestamp":1133222400000},"content-version":"vor","delay-in-days":6817,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[1987,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>We describe the clinical courses of 5 patients with Lyme disease who developed significant late complications, despite receiving tetracycline early in the course of their illness. All 5 patients had been treated for erythema chronicum migrans with a course of tetracycline that met or exceeded current recommendations. The late manifestations of Lyme disease included arthritis, cranial nerve palsy, peripheral neuropathy, chronic fatigue, and changes in mental function. Our findings suggest that the use of tetracycline at a dosage of 250 mg, 4 times a day for 10 days, as a treatment for early Lyme disease should be reconsidered. To determine optimal therapy for early Lyme disease, a study that compares an increased dosage of tetracycline with alternative treatments is indicated.<\/jats:p>","DOI":"10.1002\/art.1780300414","type":"journal-article","created":{"date-parts":[[2007,2,14]],"date-time":"2007-02-14T21:39:58Z","timestamp":1171489198000},"page":"448-450","source":"Crossref","is-referenced-by-count":59,"title":["Failure of tetracycline therapy in early lyme disease"],"prefix":"10.1002","volume":"30","author":[{"given":"Raymond J.","family":"Dattwyler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John J.","family":"Halperin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,11,29]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780200102"},{"key":"e_1_2_1_3_2","first-page":"120","article-title":"Erythema chronicum migrans","volume":"2","author":"Afzelius A","year":"1921","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_4_2","first-page":"315","article-title":"Erythema chronicum migrans Afzelii","volume":"11","author":"Hellerstrom S","year":"1930","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02095652"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01837711"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198303313081301"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198303313081302"},{"key":"e_1_2_1_9_2","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2340\/0001555564291295","article-title":"The spirochetal etiology of erythema chronicum migrans Afzelius","volume":"64","author":"Asbrink E","year":"1984","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_10_2","doi-asserted-by":"crossref","first-page":"432","DOI":"10.2340\/0001555563432436","article-title":"Acrodermatitis chronica astrophicans: erythema chronicum migrans and lymphaenosis benigna cutis: spirochetal disease","volume":"63","author":"Frithz A","year":"1983","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_11_2","first-page":"285","article-title":"Penicillin treatment of erythema chronicum migrans Afzelius","volume":"38","author":"Hollstrom E","year":"1951","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_12_2","first-page":"572","article-title":"The penicillin treatment of acrodermatitis atrophicans chronica (Herxheimer)","volume":"29","author":"Thyresson N","year":"1949","journal-title":"Acta Derm Venereol (Stockh)"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-93-1-1"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-99-1-22"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/149.3.465"},{"key":"e_1_2_1_16_2","unstructured":"DattwylerRJ ThomasJ BenachJL GolightlyMG: Cellular immune response in Lyme disease: the response to mitogens live Borrelia burgdorferi and NK cell function Second International Symposium on Lyme Disease and Related Disorders Vienna Austria September 17\u201319 1985 p21"},{"key":"e_1_2_1_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0176-6724(86)80118-3"},{"key":"e_1_2_1_18_2","first-page":"206","volume-title":"Tetracyclines and chloramphenicol, Principles and Practice of Infectious Diseases","author":"Standiford H","year":"1985"},{"key":"e_1_2_1_19_2","first-page":"549","article-title":"Susceptibility of the Lyme disease spirochete to seven antimicrobial agents","volume":"57","author":"Johnson SE","year":"1984","journal-title":"Yale J Biol Med"},{"key":"e_1_2_1_20_2","first-page":"1181","volume-title":"Antimicrobiol agents, tetracy\u2010clines and chloramphenicol, The Pharmacological Basis of Therapeutics","author":"Sande MA","year":"1980"},{"key":"e_1_2_1_21_2","unstructured":"NeumannR StanekG: Treatment and course of erythema chronicum migrans.Int J Micro Hygiene(in press)"},{"key":"e_1_2_1_22_2","first-page":"1126","volume-title":"Antimicrobial agents, penicillins and cephalosporins, The Pharmacological Basis of Therapeutics","author":"Mandell GL","year":"1980"}],"container-title":["Arthritis &amp; 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