title: Comparison of post-Lyme Borreliosis symptoms in erythema migrans patients with positive and negative Borrelia burgdorferi sensu lato skin culture.
abstract: OBJECTIVE
  Limited data exist on differences of erythema migrans patients with either positive or negative Borrelia burgdorferi sensu lato skin culture.
  
  
  METHODS
  We analyzed 252 adult patients with erythema migrans in whom skin biopsy specimen was cultured for the presence of B. burgdorferi sensu lato. Evaluations of epidemiological, clinical, and microbiological findings were conducted at baseline, 14 days, 2, 6, and 12 months after treatment with either doxycycline or cefuroxime axetil.
  
  
  RESULTS
  One hundred fifty-one (59.9%) patients had positive skin culture (86.9% B. afzelii, 8.0% B. garinii, 5.1% B. burgdorferi sensu stricto) and 101 (40.1%) had negative skin culture. Patients in the culture-positive and culture-negative groups were comparable for the basic demographic, epidemiological, clinical, and laboratory characteristics at presentation. Statistically significantly worse selected treatment outcome parameters in the culture-positive group compared with the culture-negative group were established during follow-up. Treatment failure was documented in two patients who were culture positive and in none in the culture-negative group.
  
  
  CONCLUSIONS
  Although findings for the pretreatment characteristics were comparable between the erythema migrans skin culture-positive and culture-negative patients, some parameters indicate that borrelia skin culture positivity may predict a less-favorable treatment outcome.
authors.affiliation: Department of Infectious Diseases, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Daša
authors.initials: D
authors.lastname: Stupica
authors.forename: Lara
authors.initials: L
authors.lastname: Lusa
authors.forename: Tjaša
authors.initials: T
authors.lastname: Cerar
authors.forename: Eva
authors.initials: E
authors.lastname: Ružić-Sabljić
authors.forename: Franc
authors.initials: F
authors.lastname: Strle
mesh_terms: D000328:Adult; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D025065:Borrelia burgdorferi / Q000187:drug effects* / Q000302:isolation & purification; D002444:Cefuroxime / Q000627:therapeutic use*; D004318:Doxycycline / Q000627:therapeutic use*; D005260:Female; D005929:Glossitis, Benign Migratory / Q000453:epidemiology / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D008193:Lyme Disease / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012867:Skin / Q000382:microbiology*; D017524:Slovenia / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004318:Doxycycline; D002444:Cefuroxime