Journal article
Initial Presentation and Time to Treatment in Early Lyme Disease
The American journal of tropical medicine and hygiene, v 108(4), pp 734-737
05 Apr 2023
PMID: 36746657
Abstract
The erythema migrans (EM) rash is an important initial diagnostic sign of early Lyme disease. We tested the hypothesis that patients who noticed EM first differed from those who noticed viral-like symptoms first. "EM First" partici-pants (167/271, 61.6%) had shorter illness duration before treatment (5.0 versus 6.2 days, P = 0.019), were more likely to have seen or removed a tick (P = 0.048) and to be non-Hispanic White (P = 0.025), and were less likely to present with disseminated lesions at the time of diagnosis (P = 0.003) than "Symptoms First" participants (104/271, 38.4%). In multi-variate analyses, EM First participants had a 22% decrease in time to treatment (P = 0.012) compared with Symptoms First participants, suggesting that initial presentation affects time to treatment. In a large minority of patients, EM may not be the initial sign or symptom of early Lyme disease. There is a need for rapid diagnostics and improved physician awareness of the varied manifestations of early Lyme disease.
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Details
- Title
- Initial Presentation and Time to Treatment in Early Lyme Disease
- Creators
- Alison W. Rebman - Johns Hopkins UniversityTing Yang - Johns Hopkins MedicineIsaac Yoon - Patients FirstDebra Powell - Reading HospitalSteven A. Geller - Centennial Medical GroupJohn N. Aucott - Johns Hopkins University
- Publication Details
- The American journal of tropical medicine and hygiene, v 108(4), pp 734-737
- Publisher
- American Society of Tropical Medicine & Hygiene
- Number of pages
- 4
- Grant note
- National Institutes of Health (NIH); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Global Lyme Alliance (GLA) UL1 TR003098 / National Center for Advancing Translational Sciences (NCATS); United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Advancing Translational Sciences (NCATS) NIH Roadmap for Medical Research; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA Steven and Alexandra Cohen Foundation Bay Area Lyme Foundation (BALF) Johns Hopkins Clinical Research Network (JHCRN)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000976617300016
- Scopus ID
- 2-s2.0-85152168262
- Other Identifier
- 991022161742804721