Comparison of males versus females with culture-confirmed early Lyme disease at presentation and at 11–20 years after diagnosis

Abstract

BackgroundLyme disease is the most common vector-borne infection in the United States with 300,000 estimated cases per year. ObjectiveThe 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. Methods174 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. ResultsMales 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). ConclusionMales and females with culture-confirmed early Lyme disease had similar clinical features, rates of seropositivity, and long-term outcomes.