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Clin Microbiol Infect. 2019 Jan;25(1):67-70. doi: 10.1016/j.cmi.2018.09.016. Epub 2018 Oct 2.

Non-specific symptoms in adult patients referred to a Lyme centre.

Author information

1
Lyme Centre Apeldoorn, Gelre Hospital, Apeldoorn, the Netherlands. Electronic address: t.zomer@gelre.nl.
2
Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands.
3
Lyme Centre Apeldoorn, Gelre Hospital, Apeldoorn, the Netherlands; Department of Neurology, Gelre Hospital, Apeldoorn, the Netherlands.
4
Lyme Centre Apeldoorn, Gelre Hospital, Apeldoorn, the Netherlands; Department of Internal Medicine, Gelre Hospital, Apeldoorn, the Netherlands.
5
Lyme Centre Apeldoorn, Gelre Hospital, Apeldoorn, the Netherlands; Department of Medical Microbiology and Infection Prevention, Gelre Hospital, Apeldoorn, the Netherlands.

Abstract

OBJECTIVES:

There is controversy whether non-specific symptoms can be related to previous Lyme borreliosis (LB). Positive serology can be considered a proxy for previous or persistent LB. We assessed non-specific symptoms and serology in patients suspected of LB referred to a Lyme centre.

METHODS:

Included were adult patients who visited a Lyme centre between 2008 and 2014. Before medical consultation, serum samples were taken and questionnaires on non-specific symptoms completed. The prevalence of non-specific symptoms was calculated for patients with positive and negative IgG serology. Logistic regression was used to obtain odds ratios (ORs) with 95% confidence interval (CI) for an association between positive serology and non-specific symptoms.

RESULTS:

Of 1439 included patients, 31.6% (455/1439) had positive serology. The most common non-specific symptoms were severe fatigue (61.4%, 883/1439), sleep disturbances (54.8%, 789/1439) and stiffness of neck/back (52.6%, 757/1439). The prevalence of severe fatigue was 53.0% (241/455) in patients with positive serology vs. 65.2% (642/984) in patients with negative serology (OR = 0.74; 95% CI, 0.58-0.94). The prevalence of sleep disturbances was respectively 46.2% (210/455) vs. 58.8% (579/984) (OR = 0.73; 95% CI, 0.58-0.93). The prevalence of stiffness of neck/back was respectively 47.7% (217/455) vs. 54.9% (540/984) (OR = 0.85; 95% CI, 0.67-1.06).

CONCLUSIONS:

In patients referred to a Lyme centre, non-specific symptoms did not occur more frequently in patients with positive serology compared to patients with negative serology. Hence, a questionnaire on non-specific symptoms cannot be used for identifying patients with possible post-LB symptoms in clinical practice.

KEYWORDS:

Borrelia; Fatigue; Lyme borreliosis; Lyme disease; Non-specific symptoms; Prevalence

PMID:
30287411
DOI:
10.1016/j.cmi.2018.09.016

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