title: Comparison of males versus females with culture-confirmed early Lyme disease at presentation and at 11-20 years after diagnosis.
abstract: BACKGROUND
  Lyme disease is the most common vector-borne infection in the United States with 300,000 estimated cases per year.
  
  
  OBJECTIVE
  The purpose of this study was to compare the presenting clinical features and long-term outcome of males versus females with culture-confirmed early Lyme disease.
  
  
  METHODS
  174 males and 109 females with culture-confirmed erythema migrans were entered into a prospective study with follow-up visits scheduled at six months, 12 months and annually thereafter for up to 20 years.
  
  
  RESULTS
  Males and females with early Lyme disease had a similar likelihood of having multiple erythema migrans skin lesions and had a similar number of additional subjective symptoms, such as fatigue, at study entry. Among the 71 males and 57 females able to be followed up for 11-20 years, there were no significant differences in baseline symptoms, rate of seroreactivity to Borrelia burgdorferi, or in frequency of post-treatment symptoms. Females, however, were significantly more likely than males to return for follow-up visits (P = 0.0003).
  
  
  CONCLUSIONS
  Males and females with culture-confirmed early Lyme disease had similar clinical features, rates of seropositivity, and long-term outcomes.
authors.affiliation: Division of Infectious Diseases, New York Medical College, Valhalla, NY, 10595.
authors.forename: Erica
authors.initials: E
authors.lastname: Weitzner
authors.affiliation: Baystate Medical Center, Springfield, MA, 01199.
authors.forename: Paul
authors.initials: P
authors.lastname: Visintainer
authors.affiliation: Division of Infectious Diseases, New York Medical College, Valhalla, NY, 10595. Electronic address: gwormser@nymc.edu.
authors.forename: Gary P
authors.initials: GP
authors.lastname: Wormser
mesh_terms: D000328:Adult; D000368:Aged; D025065:Borrelia burgdorferi / Q000276:immunology / Q000302:isolation & purification*; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000188:drug therapy / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D014481:United States
keywords: Borrelia burgdorferi; Gender; Lyme disease; Sex-based analysis