{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,4]],"date-time":"2025-07-04T11:49:57Z","timestamp":1751629797549},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"7-8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Lyme disease is a continuing threat to military personnel operating in arboriferous and mountainous environments. Here we present the case of a 24-year-old Second Lieutenant, a recent graduate from the United States Military Academy, with a history of Lyme disease who developed recurrent knee effusions following surgery to correct a hip impingement. Although gonococcal arthritis was initially suspected from preliminary laboratory results, a comprehensive evaluation contradicted this diagnosis. Despite antibiotic therapy, aspiration of the effusions, and steroid treatment to control inflammation, the condition of the patient deteriorated to the point where he was found to be unfit for duty and subsequently discharged from active military service. This case illustrates the profound effect that latent Lyme disease can have on the quality of life and the career of an active duty military member. It highlights the need for increased surveillance for Borrelia burgdorferi (B. burgdorferi) in military training areas and for the early and aggressive diagnosis and treatment of military personnel who present with the symptoms of acute Lyme disease.<\/jats:p>","DOI":"10.1093\/milmed\/usz026","type":"journal-article","created":{"date-parts":[[2019,3,6]],"date-time":"2019-03-06T06:24:42Z","timestamp":1551853482000},"page":"e368-e370","source":"Crossref","is-referenced-by-count":7,"title":["Latent Lyme Disease Resulting in Chronic Arthritis and Early Career Termination in a United States Army Officer"],"prefix":"10.1093","volume":"184","author":[{"given":"Thomas","family":"Weiss","sequence":"first","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"White","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Posner","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J Kenneth","family":"Wickiser","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael A","family":"Washington","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Barnhill","sequence":"additional","affiliation":[{"name":"Department of Chemistry and Life Science, Bartlett Hall, 753 Cullum Road, West Point, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,3,6]]},"reference":[{"issue":"4","key":"2019070906462100700_usz026C1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1016\/j.cll.2015.07.004","article-title":"Borrelia burgdorferi pathogenesis and the immune response","volume":"35","author":"Petzke","year":"2015","journal-title":"Clin Lab Med"},{"key":"2019070906462100700_usz026C2","first-page":"3","article-title":"Spatiotemporal evolution of erythema migrans, the hallmark rash of lyme","volume":"2","author":"Vig","year":"2014","journal-title":"Infection"},{"issue":"9814","key":"2019070906462100700_usz026C3","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","article-title":"Lyme borreliosis","volume":"379","author":"Stanek","year":"2012","journal-title":"Lancet"},{"issue":"1","key":"2019070906462100700_usz026C4","doi-asserted-by":"crossref","first-page":"291","DOI":"10.2147\/IJGM.S44114","article-title":"Review of evidence for immune evasion and persistent infection in Lyme disease","volume":"6","author":"Berndtson","year":"2013","journal-title":"Int J Gen Med"},{"issue":"1","key":"2019070906462100700_usz026C5","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1186\/1742-2094-5-40","article-title":"Persisting atypical and cystic forms of Borrelia burgdorferi and local inflammation in Lyme neuroborreliosis","volume":"5","author":"Miklossy","year":"2008","journal-title":"J 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States","volume":"22","author":"Rossi","year":"2015","journal-title":"MSMR"},{"key":"2019070906462100700_usz026C9","author":"Farrell","year":"2012"},{"key":"2019070906462100700_usz026C10","doi-asserted-by":"crossref","DOI":"10.4049\/jimmunol.1701248","article-title":"IL-10 deficiency reveals a role for TLR2-dependent bystander activation of T cells in Lyme arthritis","author":"Whiteside","year":"2018","journal-title":"J Immunol"},{"issue":"4","key":"2019070906462100700_usz026C11","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1084\/jem.20011870","article-title":"An immune evasion mechanism for spirochetal persistence in Lyme borreliosis","volume":"195","author":"Liang","year":"2002","journal-title":"J Exp Med"},{"issue":"9814","key":"2019070906462100700_usz026C12","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","article-title":"Lyme borreliosis","volume":"379","author":"Stanek","year":"2012","journal-title":"Lancet"},{"issue":"8","key":"2019070906462100700_usz026C13","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1007\/BF00328508","article-title":"Treatment of Lyme borreliosis","volume":"236","author":"Kohlhepp","year":"1989","journal-title":"J Neurol"}],"container-title":["Military 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