Long-term follow-up of patients with culture-confirmed lyme disease

Chronic Lyme Disease: A Review

“…Many studies have shown that Lyme disease is treated successfully with antibiotics in the majority of cases, and patients with objective evidence of treatment failure are rare with currently recommended regimens [11][12][13][14]. Patients with late manifestations can have a slower response to therapy, sometimes taking weeks or months to recover [15][16][17][18][19][20][21][22][23].…”

“…From 10-20% of such patients have persistent or intermittent subjective symptoms of mild to moderate intensity 12 months after completion of therapy ( Table 4). The most common postLyme disease symptoms are fatigue, arthralgias, myalgias, headache, neck stiffness, paresthesias, sleeplessness, irritability, and difficulty with memory, word finding, and concentration [12,13,[25][26][27][28]. The appearance of post-Lyme disease symptoms seems to correlate with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy [12,[29][30][31][32][33]; but not with the duration of the initial antibiotic therapy [13,23].…”

“…The most common postLyme disease symptoms are fatigue, arthralgias, myalgias, headache, neck stiffness, paresthesias, sleeplessness, irritability, and difficulty with memory, word finding, and concentration [12,13,[25][26][27][28]. The appearance of post-Lyme disease symptoms seems to correlate with disseminated disease, a greater severity of illness at presentation, and delayed antibiotic therapy [12,[29][30][31][32][33]; but not with the duration of the initial antibiotic therapy [13,23]. Children appear to be less likely to develop post-Lyme disease symptoms [34][35][36][37][38][39][40][41][42].…”

“…Physicians also gained more experience following patients who were treated with antibiotics, and, with longer periods of observation, it became apparent that these nonspecific symptoms frequently resolved without further antibiotic treatment, and that antibiotic therapy did not hasten their resolution [33,54]. Further studies also showed that symptomatic patients were not more likely to be seropositive than patients without symptoms and that patients did not develop objective manifestations of late Lyme disease [12,18]. While earlier, smaller studies showed a higher prevalence of recurrent arthralgias, symptoms of memory impairment, and other symptoms in persons with a history of Lyme disease compared with controls [32,33], larger cohort studies showed no differences on physical examination and neurocognitive testing [55], and no difference in the frequency of symptoms between patients with Lyme disease and age-matched controls [39].…”

Serological and Clinical one year follow-up of Patients with Erythema migrans treated in a Romanian Infectious Disease Hospital

“…Seropositivity to Borrelia burgdorferi sl, either at presentation or follow-up, was found in independent studies not to be a risk factor for treatment failure. [23,[25][26][27][28][29] Persistence of IgM and IgG antibodies was described even 10-20 years after infection in asymptomatic patients. [30] It might be assumed that sustained positive titers indicate a long-term serologic memory that results from an antigen-independent polyclonal activation and differentiation of memory B cells.…”