FHU INOVPAIN, centre d'évaluation et de traitement de la douleur, CHU de Timone, pôle de neurosciences cliniques, 13005 Marseille, France.
IRD, SSA, VITROME, IHU - méditerranée infection, Aix-Marseille université, AP-HM, 13005 Marseille, France.
Med Mal Infect. 2019 Mar;49(2):157-166. doi: 10.1016/j.medmal.2019.01.008. Epub 2019 Feb 11.
Lyme disease is caused by bacteria of the B. burgdorferi sensu lato complex, and can give polymorphic clinical manifestations that can affect several organs such as the skin, the central nervous system, or the joints. In recent years, patients' associations and physicians have been supporting the hypothesis that this infection would manifest as chronic generalized musculoskeletal pain symptoms, named "chronic Lyme disease". Fibromyalgia is a clinical presentation characterized by chronic generalized musculoskeletal pain with a major impact on quality of life and social and psychological functioning. We analyzed existing literature data on pain syndromes associated with Lyme disease (post-treatment Lyme disease syndrome) or tick bites (polymorphic symptoms after a tick bite). We also analyzed existing data on the diagnosis, pathophysiology, and treatment of fibromyalgia. Our review shows that post-treatment Lyme disease syndrome has characteristics very close to post-infectious fibromyalgia. On the other hand, patients presenting for Lyme disease screening because of chronic generalized musculoskeletal pain symptoms after a tick bite should also be screened for fibromyalgia to allow appropriate management. Antibiotics are not recommended here.
莱姆病由伯氏疏螺旋体亚种复合体细菌引起，可引起影响皮肤、中枢神经系统或关节等多个器官的多态性临床表现。近年来，患者协会和医生一直支持这样一种假设，即这种感染会表现为慢性全身性肌肉骨骼疼痛症状，称为“慢性莱姆病”。纤维肌痛是一种以慢性全身性肌肉骨骼疼痛为特征的临床表现，对生活质量以及社会和心理功能有重大影响。我们分析了与莱姆病（治疗后莱姆病综合征）或蜱叮咬（蜱叮咬后的多态性症状）相关的疼痛综合征的现有文献数据。我们还分析了纤维肌痛的诊断、病理生理学和治疗的现有数据。我们的综述表明，治疗后莱姆病综合征的特征与感染后纤维肌痛非常接近。另一方面，由于蜱叮咬后出现慢性全身性肌肉骨骼疼痛症状而就诊于莱姆病筛查的患者也应筛查纤维肌痛，以便进行适当的管理。不建议在此使用抗生素。
