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Pathogens
Volume 13
Issue 2
10.3390/pathogens13020137
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Article

Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?

by
Katarina Ogrinc
1,
Petra Bogovič
1,
Vera Maraspin
1,
Stanka Lotrič-Furlan
1,
Tereza Rojko
1,
Andrej Kastrin
2,
Klemen Strle
3,
Gary P. Wormser
4 and
Franc Strle
1,*
1
Department of Infectious Diseases, University Medical Centre Ljubljana, 1525 Ljubljana, Slovenia
2
Institute for Biostatistics and Medical Informatics, University of Ljubljana, 1000 Ljubljana, Slovenia
3
Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Tufts University, Boston, MA 02111, USA
4
Division of Infectious Diseases, New York Medical College, Valhalla, NY 10595, USA
*
Author to whom correspondence should be addressed.
Pathogens 2024, 13(2), 137; https://doi.org/10.3390/pathogens13020137
Submission received: 11 December 2023 / Revised: 6 January 2024 / Accepted: 30 January 2024 / Published: 1 February 2024
(This article belongs to the Section Ticks)
Versions Notes

Abstract

In prior studies, the skin lesion erythema migrans (EM) was present for a longer time period before diagnosis of concomitant borrelial meningoradiculoneuritis (Bannwarth’s syndrome) compared to EM patients without neurologic symptoms. To determine if this observation pertains to other manifestations of Lyme neuroborreliosis (LNB), we compared EM characteristics in patients with borrelial meningoradiculoneuritis (n = 122) to those with aseptic meningitis without radicular pain (n = 72 patients), and to patients with EM but without neurologic involvement (n = 12,384). We also assessed factors that might impact duration. We found that the duration of EM at diagnosis in patients with borrelial meningoradiculoneuritis was not significantly different compared with those with LNB without radicular pain (34 vs. 26 days; p = 0.227). The duration of EM for each of these clinical presentations of LNB, however, was significantly longer than in patients with EM without LNB (10 days; p < 0.001). Contributing factors to this difference might have been that patients with LNB failed to recognize that they had EM or were unaware of the importance of not delaying antibiotic treatment for EM. In conclusion, the duration of the EM skin lesion in EM patients with LNB is longer than in patients with just EM, irrespective of the type of LNB.
Keywords: Lyme borreliosis; Lyme disease; erythema migrans; Bannwarth’s syndrome; borrelial meningoradiculoneuritis; Lyme neuroborreliosis; Borrelia burgdorferi sensu lato Lyme borreliosis; Lyme disease; erythema migrans; Bannwarth’s syndrome; borrelial meningoradiculoneuritis; Lyme neuroborreliosis; Borrelia burgdorferi sensu lato

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MDPI and ACS Style

Ogrinc, K.; Bogovič, P.; Maraspin, V.; Lotrič-Furlan, S.; Rojko, T.; Kastrin, A.; Strle, K.; Wormser, G.P.; Strle, F. Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement? Pathogens 2024, 13, 137. https://doi.org/10.3390/pathogens13020137

AMA Style

Ogrinc K, Bogovič P, Maraspin V, Lotrič-Furlan S, Rojko T, Kastrin A, Strle K, Wormser GP, Strle F. Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement? Pathogens. 2024; 13(2):137. https://doi.org/10.3390/pathogens13020137

Chicago/Turabian Style

Ogrinc, Katarina, Petra Bogovič, Vera Maraspin, Stanka Lotrič-Furlan, Tereza Rojko, Andrej Kastrin, Klemen Strle, Gary P. Wormser, and Franc Strle. 2024. "Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement?" Pathogens 13, no. 2: 137. https://doi.org/10.3390/pathogens13020137

APA Style

Ogrinc, K., Bogovič, P., Maraspin, V., Lotrič-Furlan, S., Rojko, T., Kastrin, A., Strle, K., Wormser, G. P., & Strle, F. (2024). Why Is the Duration of Erythema Migrans at Diagnosis Longer in Patients with Lyme Neuroborreliosis Than in Those without Neurologic Involvement? Pathogens, 13(2), 137. https://doi.org/10.3390/pathogens13020137

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