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. 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

Erica Weitzner  1 , Donna McKenna  1 , John Nowakowski  1 , Carol Scavarda  1 , Rhea Dornbush  2 , Susan Bittker  1 , Denise Cooper  1 , Robert B Nadelman  1 , Paul Visintainer  3 , Ira Schwartz  4 , Gary P Wormser  1
Affiliations

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

Erica Weitzner et al. Clin Infect Dis. .

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.

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References

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