Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis
Abstract
:1. Introduction
2. Experimental Section
2.1. Setting and Participants
2.2. Evaluation of Patients
2.3. Microbiologic Methods
2.4. Statistical Methods
3. Results
3.1. Pre-Treatment Characteristics
3.2. Microbiologic Results According to Age
3.3. Treatment Outcome According to Age
4. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | Young | Middle-Aged | Elderly | p Value a |
---|---|---|---|---|
369 (30.2%) | 627 (51.4%) | 224 (18.4%) | ||
Male sex | 214 (58) | 243 (38.8) | 88 (39.3) | <0.001 |
History of Lyme borreliosis | 0.002 | |||
Yes | 17 (14.2) | 72 (60) | 31 (25.8) | |
No | 352 (32) | 555 (50.5) | 193 (17.5) | |
Comorbidities b | 54 (14.6) | 298 (47.5) | 171 (76.3) | <0.001 |
Tick bite c | 179 (48.5) | 319 (50.9) | 117 (52.2) | 0.642 |
Days since EM first observed | 10 (5–24) | 11 (5–25) | 10 (4–28) | 0.835 |
Diameter of primary EM, cm | 15 (9–22) | 14 (9–20) | 14 (10.8–24) | 0.194 |
EM with central clearing d | 205 (55.6) | 288 (45.9) | 112 (50.0) | 0.013 |
Multiple EM | <0.001 | |||
Yes | 80 (41.6) | 97 (49.7) | 18 (9.0) | |
No | 289 (28.2) | 530 (51.7) | 206 (20.1) | |
LB-associated constitutional | 121 (32.8) | 190 (30.3) | 62 (27.7) | 0.415 |
Symptoms e | ||||
Fatigue | 53 (14.4) | 98 (15.6) | 33 (14.7) | 0.853 |
Arthralgia | 45 (12.2) | 67 (10.7) | 20 (8.9) | 0.457 |
Headache | 47 (12.7) | 81 (12.9) | 26 (11.6) | 0.877 |
Myalgia | 18 (4.9) | 55 (8.8) | 14 (6.3) | 0.060 |
Seropositive f | 191/358 (53.4) | 331/614 (53.9) | 140/220 (63.6) | 0.027 |
Skin culture positive | 187/340 (55.0) | 331/588 (56.3) | 117/214 (54.7) | 0.888 |
B. afzelii | 177 (94.7) | 296 (89.4) | 95 (81.2) | 0.004 g |
B. garinii | 7 (3.7) | 19 (5.7) | 14 (12.0) | |
B. burgdorferi sensu stricto | 1 (0.5) | 5 (1.5) | 5 (4.3) | |
Unidentified h | 2 (1.1) | 11 (3.3) | 3 (2.6) | |
Blood culture positive | 5/340 (1.5) | 7/614 (1.1) | 6/220 (2.7) | 0.244 |
All | Young | Middle-Aged | Elderly | p Value a | |
---|---|---|---|---|---|
n = 1220 | n = 369 | n = 627 | n = 224 | ||
14 days post-enrolment | 258/1199 (21.5) | 76/362 (21.0) | 135/616 (21.9) | 47/221 (21.3) | 0.940 |
2 months post-enrolment | 172/1176 (14.6) | 41/351 (11.7) | 95/605 (15.7) | 36/220 (16.4) | 0.171 |
6 months post-enrolment | 101/1032 (9.8) | 17/291 (5.8) | 61/544 (11.2) | 23/197 (11.7) | 0.028 |
12 months post-enrolment | 59/977 (6.0) | 10/271 (3.7) | 34/513 (6.6) | 15/193 (7.8) | 0.137 |
Last evaluable visit | 85/1217 (6.9) | 19/368 (5.2) | 49/625 (7.8) | 17/224 (7.6) | 0.258 |
OR (95% CI) a | p Value b | |
---|---|---|
Age | 0.038 | |
Middle-aged vs. young | 1.57 (1.04–2.37) | 0.031 |
Elderly vs. young | 1.94 (1.12–3.37) | 0.018 |
Time from enrolment | <0.001 | |
2 months vs. 14 days | 0.48 (0.37–0.63) | <0.001 |
6 vs. 2 months | 0.50 (0.36–0.68) | <0.001 |
12 vs. 6 months | 0.47 (0.32–0.70) | <0.001 |
Sex (female vs. male) | 1.43 (1.01–2.02) | 0.041 |
Presence of comorbidities | 0.85 (0.59–1.24) | 0.399 |
Multiple EM vs. solitary EM | 1.67 (1.08–2.58) | 0.022 |
Presence of LB-associated constitutional symptoms at enrolment (yes vs. no) | 8.47 (5.79–12.38) | <0.001 |
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Boršič, K.; Blagus, R.; Cerar, T.; Strle, F.; Stupica, D. Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis. J. Clin. Med. 2018, 7, 506. https://doi.org/10.3390/jcm7120506
Boršič K, Blagus R, Cerar T, Strle F, Stupica D. Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis. Journal of Clinical Medicine. 2018; 7(12):506. https://doi.org/10.3390/jcm7120506
Chicago/Turabian StyleBoršič, Katarina, Rok Blagus, Tjaša Cerar, Franc Strle, and Daša Stupica. 2018. "Clinical Course, Serologic Response, and Long-Term Outcome in Elderly Patients with Early Lyme Borreliosis" Journal of Clinical Medicine 7, no. 12: 506. https://doi.org/10.3390/jcm7120506