Wheelchair-Bound Man Walks Again After Lyme Disease Treatment

SEVERE KNEE PAIN?
WHEN LYME DISEASE
IS MISSED

Lyme disease can worsen underlying joint disease and, in some cases, dramatically impair mobility when the infection goes unrecognized.

In this case report, “Exacerbation of Osteoarthritic Joint Pain by Lyme Disease,” Bennani and colleagues demonstrate how identifying an underlying tick-borne infection dramatically improved a patient’s quality of life.

Wheelchair-Bound From Severe Knee Pain

A 63-year-old man presented with progressively worsening pain in both knees over several months.

He had previously undergone bilateral knee arthroscopies for meniscal tears and recently received corticosteroid injections, but his symptoms continued to worsen.

“Before treatment, our patient was wheelchair-bound due to the combination of existing osteoarthritis and the manifestation of Lyme disease in his knees.”

The authors note that while corticosteroids may temporarily reduce inflammation, an untreated bacterial infection can continue damaging joint tissue.

The patient also mentioned an important clue: he had briefly taken erythromycin for an upper respiratory infection and noticed his knees improved while on the antibiotic.

Why Lyme Disease Was Finally Considered

The patient, who worked as a chief executive officer (CEO), was also an avid hunter and reported that his dog had previously been diagnosed with Lyme disease.

Given that the patient’s dog had Lyme disease, Lyme IgG and Lyme IgM studies were ordered.

Testing returned positive for Lyme disease.

The patient was treated with doxycycline.

Improvement After Lyme Disease Treatment

“Upon completion of doxycycline therapy, our patient noted significant improvement in his knee pain,” the authors wrote.

His improvement was so significant that the patient no longer required a wheelchair and was able to cancel his bilateral knee replacement surgery.

This case highlights how Lyme disease may aggravate existing osteoarthritis and dramatically worsen mobility when the infection is not recognized.

For more on Lyme arthritis, see successful treatment for Lyme arthritis after knee surgery.

Why This Case Matters

Lyme disease can mimic or worsen other orthopedic conditions, particularly in patients with preexisting joint disease.

Patients with outdoor exposure, hunting activities, or frequent tick exposure may face higher risk.

In some cases, identifying Lyme disease may help patients avoid unnecessary surgeries or prolonged disability.

The authors conclude:

• “Our patient was able to avoid a costly, high-risk surgical procedure with the detection and treatment of his Lyme disease.”
• “Lyme disease should always be a consideration in the differential diagnosis of patients who have lived or have traveled to areas that are endemic to the disease and who tend to have outdoor lifestyles.”

Clinical Takeaway

Lyme disease may worsen underlying osteoarthritis and significantly impair mobility when the infection is overlooked.

Recognizing Lyme arthritis early may improve function, reduce pain, and help some patients avoid unnecessary procedures.

Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.

Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention