Abstract
PurposeA subset of patients treated for Lyme disease report persistent or recurrent symptoms of unknown etiology named post-treatment Lyme disease syndrome (PTLDS). This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of PTLDS over time.MethodsSixty-three participants with erythema migrans and systemic symptoms were enrolled in a prospective cohort study. Participants underwent physical exams and clinical assessments, and completed the SF-36 (daily life functioning) and the Beck Depression Inventory, Second Edition (BDI-II) (depression), at each of five visits over a period of 6 months.ResultsSigns of Lyme disease disappeared post-treatment; however, new-onset patient-reported symptoms increased or plateaued over time. At 6 months, 36% of patients reported new-onset fatigue, 20% widespread pain, and 45% neurocognitive difficulties. However, less than 10% reported greater than “minimal” depression across the entire period. Those with PTLDS (36%) did not differ significantly from those without with respect to demographics, pre-treatment SF-36, and BDI-II scores. Statistically significant differences were found over time on the Role Physical, Vitality, Social Functioning, Role Emotional, and Mental Health subscales (with a trend toward significance for the remaining three subscales of Physical Functioning, Bodily Pain, and General Health) of the SF-36 between those with an eventual PTLDS diagnosis and those without when measured at 6 months.ConclusionsUnlike clinical signs of Lyme disease, new-onset symptoms are reported by a subset of participants without evidence of depressive symptomatology. Patients who developed PTLDS had significantly lower life functioning compared to those without PTLDS. We propose future avenues for researching infection-triggered symptoms resulting from multiple mechanisms.
Highlights
Lyme disease, caused by the spirochete bacteria Borrelia burgdorferi, is the most common vector-borne infectious disease in North America
This study aims to describe a cohort of participants with early, untreated Lyme disease, and characterize post-treatment symptomatology and functional impact of post-treatment Lyme disease syndrome (PTLDS) over time
Given that depression symptomatology has been hypothesized to play a role in the development of PTLDS, the Beck Depression Inventory, Second Edition (BDI-II) [21], was administered at each visit
Summary
Lyme disease, caused by the spirochete bacteria Borrelia burgdorferi, is the most common vector-borne infectious disease in North America. More than 38,000 new cases were reported in the United States in 2009 [1], but. Disseminated infection may be associated with VII nerve palsy, cardiac disease, meningitis, and rarely, evidence of encephalitis [6]. 60% of cases may develop ‘‘late’’ Lyme disease with joint pain and arthritis [6]. Encephalitis with focal abnormalities on neuroimaging is rare in the United States [7]. Patient-reported symptoms, such as fatigue, cognitive dysfunction, and musculoskeletal pain, are common in both early and late phases of untreated illness [8, 9]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
