{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:52:18Z","timestamp":1791917538233,"version":"4.3.4"},"reference-count":16,"publisher":"BMJ","issue":"7","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,6,12]]},"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:p>A man in his 40s with no prior orthopaedic history presented to an infectious disease clinic with persistent left knee pain and swelling following a traumatic meniscal tear and ensuing prodromal period of fever and chills. Aspiration of the left knee joint revealed a white cell count of 21.0\u2009\u00d710<jats:sup>9<\/jats:sup>\/L (83% neutrophils) with negative Gram stain and culture. However, Lyme PCR was positive and accompanied by serologies consistent with Lyme arthritis. He was treated with a standard course of antibiotic therapy with subsequent resolution of joint effusion and significant improvement in pain.<\/jats:p>\n               <jats:p>This is to our knowledge the first report in the literature of Lyme arthritis seemingly provoked by traumatic knee injury. We propose disruption of normal joint anatomy and ensuing inflammation in response to acute injury incited and accelerated migration of previously latent <jats:italic>Borrelia burgdorferi<\/jats:italic> spirochetal infection into surrounding synovial tissue, leading to enhanced inflammatory activity and exacerbation of knee pain.<\/jats:p>","DOI":"10.1136\/bcr-2023-255532","type":"journal-article","created":{"date-parts":[[2023,7,5]],"date-time":"2023-07-05T16:40:27Z","timestamp":1688575227000},"page":"e255532","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Trauma-related Lyme arthritis"],"prefix":"10.1136","volume":"16","author":[{"suffix":"IV","given":"John","family":"Roberts","sequence":"first","affiliation":[{"name":"Tufts University School of Medicine, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Merchant","sequence":"additional","affiliation":[{"name":"Tufts University School of Medicine, Boston, Massachusetts, USA"},{"name":"Infectious Diseases, Tufts Medical Center, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2023,7,5]]},"reference":[{"key":"2025082709023885000_16.7.e255532.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2015.05.005"},{"key":"2025082709023885000_16.7.e255532.2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2702.202731"},{"key":"2025082709023885000_16.7.e255532.3","doi-asserted-by":"publisher","DOI":"10.3201\/eid2109.150417"},{"key":"2025082709023885000_16.7.e255532.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.02.010"},{"key":"2025082709023885000_16.7.e255532.5","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6609a1"},{"key":"2025082709023885000_16.7.e255532.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2015.02.004"},{"key":"2025082709023885000_16.7.e255532.7","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1038\/s41584-021-00648-5","article-title":"Lyme arthritis: linking infection, inflammation and autoimmunity","volume":"17","author":"Lochhead","year":"2021","journal-title":"Nat Rev Rheumatol"},{"key":"2025082709023885000_16.7.e255532.8","doi-asserted-by":"crossref","first-page":"281","DOI":"10.3390\/pathogens10030281","article-title":"The brilliance of Borrelia: mechanisms of host immune evasion by Lyme disease-causing Spirochetes","volume":"10","author":"Anderson","year":"2021","journal-title":"Pathogens"},{"key":"2025082709023885000_16.7.e255532.9","doi-asserted-by":"crossref","first-page":"563","DOI":"10.1016\/j.idc.2022.03.006","article-title":"Lyme arthritis","volume":"36","author":"Arvikar","year":"2022","journal-title":"Infect Dis Clin North Am"},{"key":"2025082709023885000_16.7.e255532.10","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-107-5-725"},{"key":"2025082709023885000_16.7.e255532.11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199401273300401"},{"key":"2025082709023885000_16.7.e255532.12","first-page":"590","article-title":"Recommendations for test performance and interpretation from the second national conference on serologic diagnosis of Lyme disease","volume":"44","year":"1995","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"2025082709023885000_16.7.e255532.13","doi-asserted-by":"publisher","DOI":"10.1086\/589242"},{"key":"2025082709023885000_16.7.e255532.14","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200838110-00003"},{"key":"2025082709023885000_16.7.e255532.15","doi-asserted-by":"crossref","unstructured":"Seldes R , Glasgow SG , Torg JS . Atraumatic spontaneous Hemarthrosis associated with Lyme arthritis. A case report. Clin Orthop Relat Res 1993:269\u201371.","DOI":"10.1097\/00003086-199312000-00044"},{"key":"2025082709023885000_16.7.e255532.16","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.CC.16.00031"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-255532","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:02:46Z","timestamp":1756310566000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-255532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7]]},"references-count":16,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7,5]]},"published-print":{"date-parts":[[2023,7]]}},"alternative-id":["10.1136\/bcr-2023-255532"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-255532","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7]]}}}