Does chlamydia trachomatis influence manifestations of Lyme Arthritis?

Lyme arthritis, caused by the tick-borne spirochete Borrelia burgdorferi, produces typically intermittent episodes of arthritis of the larger joints, usually the knee joints. A number of patients, however, develop arthritis more closely resembling Reiter's syndrome, i.e., heel and ankle involvement. We studied the clinical features of ten patients who developed arthritis after a tick bite and who had shown erythema migrans and related it to the presence of evidence of Chlamydia trachomatis infection. Along with typical signs of Lyme arthritis we observed heel and ankle involvement. Chlamydia trachomatis was found in smears in 4 cases, whereas no patient had antichlamydial antibodies. However, evidence of Chlamydia trachomatis did not correlate with signs considered typical of Reiter's syndrome. Therefore, Lyme arthritis may have some arthritic manifestations resembling Reiter's syndrome, but this seems unrelated to the presence of Chlamydia trachomatis. Moreover, the arthritis is not associated with HLA-B27.