Long-term prognosis of patients treated for erythema migrans in France.
BACKGROUND
The long-term prognosis of patients treated for erythema migrans has only rarely been assessed.


OBJECTIVE
To evaluate the clinical characteristics and long-term prognosis of patients treated for erythema migrans in the region of Alsace, France.


METHODS
In a prospective study, 56 consecutive patients presenting with erythema migrans at the Strasbourg University Hospital between 1995 and 1999 were examined and a Borrelia burgdorferi enzyme immunoassay was performed. Patients were treated with tetracyclines or amoxycillin. Patients were re-examined 6 weeks later and a telephone interview was performed in summer 2000 to evaluate the long-term outcome.


RESULTS
There were 25 women and 31 men of mean age 49 years presenting with single (n = 54) or multiple (n = 2) erythema migrans lesions. At the time of diagnosis, 30% of the patients had systemic signs, myalgias or arthralgias and only 36% of 50 patients were seroreactive against B. burgdorferi. None of the 51 patients evaluated at 6 weeks and none of the 37 patients interviewed after a median delay of 3 years had developed complications attributable to Lyme borreliosis.


CONCLUSIONS
The prognosis of patients treated for Lyme borreliosis in this part of France is excellent. Therefore, a complete clinical examination is sufficient as an initial evaluation and long-term follow-up is not necessary.
Lipsker
D
D
Services de Dermatologie, de Maladies Infectieuses and Laboratoire de Bactériologie des Hôpitaux Universitaires de Strasbourg, 1 place de l'hôpital, 67091 Strasbourg cedex, France. dlipsker@noos.fr
Antoni-Bach
N
N
Hansmann
Y
Y
Jaulhac
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D025065:Borrelia burgdorferi / Q000302:isolation & purification; D002648:Child; D015787:Erythema Chronicum Migrans / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010406:Penicillins / Q000627:therapeutic use; D011379:Prognosis; D011446:Prospective Studies; D013754:Tetracyclines; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D010406:Penicillins; D013754:Tetracyclines; D000658:Amoxicillin