TY - JOUR
T1 - Initial Presentation and Time to Treatment in Early Lyme Disease
AU - Rebman, Alison W.
AU - Yang, Ting
AU - Yoon, Isaac
AU - Powell, Debra
AU - Geller, Steven A.
AU - Aucott, John N.
N1 - Publisher Copyright:
© 2023 The American Society of Tropical Medicine and Hygiene.
PY - 2023/4
Y1 - 2023/4
N2 - 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"participants (167/271, 61.6%) had shorter illness duration before treatment (5.0 versus 6.2 days, P50.019), were more likely to have seen or removed a tick (P50.048) and to be non-Hispanic White (P50.025), and were less likely to present with disseminated lesions at the time of diagnosis (P50.003) than "Symptoms First"participants (104/271, 38.4%). In multivariate analyses, EM First participants had a 22% decrease in time to treatment (P50.012) 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.
AB - 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"participants (167/271, 61.6%) had shorter illness duration before treatment (5.0 versus 6.2 days, P50.019), were more likely to have seen or removed a tick (P50.048) and to be non-Hispanic White (P50.025), and were less likely to present with disseminated lesions at the time of diagnosis (P50.003) than "Symptoms First"participants (104/271, 38.4%). In multivariate analyses, EM First participants had a 22% decrease in time to treatment (P50.012) 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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U2 - 10.4269/ajtmh.22-0437
DO - 10.4269/ajtmh.22-0437
M3 - Article
C2 - 36746657
AN - SCOPUS:85152168262
SN - 0002-9637
VL - 108
SP - 734
EP - 737
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 4
ER -