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Clin Infect Dis. 2015 Dec 15;61(12):1800-6. doi: 10.1093/cid/civ735. Epub 2015 Sep 18.

Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.

Author information

1
Division of Infectious Diseases.
2
Department of Psychiatry.
3
Baystate Medical Center, Springfield, Massachusetts.
4
Department of Microbiology and Immunology, New York Medical College, Valhalla.

Abstract

BACKGROUND:

Lyme disease patients with erythema migrans are said to have post-treatment Lyme disease symptoms (PTLDS) if there is persistence of subjective symptoms for at least 6 months following antibiotic treatment and resolution of the skin lesion. The purpose of this study was to characterize PTLDS in patients with culture-confirmed early Lyme disease followed for >10 years.

METHODS:

Adult patients with erythema migrans with a positive skin or blood culture for Borrelia burgdorferi were enrolled in a prospective study beginning in 1991 and followed up at 6 months and annually thereafter to determine the long-term outcome of this infection. The genotype of the infecting strain of B. burgdorferi was evaluated in subjects with PTLDS.

RESULTS:

One hundred twenty-eight subjects with culture-confirmed early Lyme disease, of whom 55% were male, were followed for a mean ± SD of 14.98 ± 2.71 years (median = 15 years; range = 11-20 years). Fourteen (10.9%) were regarded as having possible PTLDS, but only 6 (4.7%) had PTLDS documented at their last study visit. Nine (64.3%) had only a single symptom. None of the 6 with PTLDS at their last visit was considered to be functionally impaired by the symptom(s). PTLDS was not associated with a particular genotype of B. burgdorferi.

CONCLUSIONS:

PTLDS may persist for >10 years in some patients with culture-confirmed early Lyme disease. Such long-standing symptoms were not associated with functional impairment or a particular strain of B. burgdorferi.

KEYWORDS:

Borrelia burgdorferi; Lyme; Lyme disease; erythema migrans; post-treatment Lyme disease symptoms

PMID:
26385994
PMCID:
PMC4657537
DOI:
10.1093/cid/civ735
[Indexed for MEDLINE]
Free PMC Article

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