title: Long-term Assessment of Post-Treatment Symptoms in Patients With Culture-Confirmed Early Lyme Disease.
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.
authors.affiliation: Division of Infectious Diseases.
authors.forename: Erica
authors.initials: E
authors.lastname: Weitzner
authors.affiliation: Division of Infectious Diseases.
authors.forename: Donna
authors.initials: D
authors.lastname: McKenna
authors.affiliation: Division of Infectious Diseases.
authors.forename: John
authors.initials: J
authors.lastname: Nowakowski
authors.affiliation: Division of Infectious Diseases.
authors.forename: Carol
authors.initials: C
authors.lastname: Scavarda
authors.affiliation: Department of Psychiatry.
authors.forename: Rhea
authors.initials: R
authors.lastname: Dornbush
authors.affiliation: Division of Infectious Diseases.
authors.forename: Susan
authors.initials: S
authors.lastname: Bittker
authors.affiliation: Division of Infectious Diseases.
authors.forename: Denise
authors.initials: D
authors.lastname: Cooper
authors.affiliation: Division of Infectious Diseases.
authors.forename: Robert B
authors.initials: RB
authors.lastname: Nadelman
authors.affiliation: Baystate Medical Center, Springfield, Massachusetts.
authors.forename: Paul
authors.initials: P
authors.lastname: Visintainer
authors.affiliation: Department of Microbiology and Immunology, New York Medical College, Valhalla.
authors.forename: Ira
authors.initials: I
authors.lastname: Schwartz
authors.affiliation: Division of Infectious Diseases.
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
mesh_terms: D000328:Adult; D000368:Aged; D001769:Blood / Q000382:microbiology; D025065:Borrelia burgdorferi / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D004890:Erythema / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005838:Genotype; D006801:Humans; D008193:Lyme Disease / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012867:Skin / Q000382:microbiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Borrelia burgdorferi; Lyme; Lyme disease; erythema migrans; post-treatment Lyme disease symptoms