Long-term Assessment of Fatigue in Patients with Culture-confirmed Lyme Disease - 23/01/15
, Erica Weitzner, BS, Donna McKenna, NP, Robert B. Nadelman, MD, Carol Scavarda, RN, John Nowakowski, MDAbstract |
Background |
Fatigue is a common symptom with numerous causes. Severe fatigue is thought to be an important manifestation of post-treatment Lyme disease syndrome. The frequency with which severe fatigue occurs as a long-term sequela in prospectively followed patients with Lyme disease is unknown.
Methods |
Patients with culture-confirmed Lyme disease who originally presented with erythema migrans have been evaluated annually in a prospective study to determine their long-term outcome. In 2011-2013, subjects were evaluated for fatigue using an 11-item Fatigue Severity Scale (FSS-11) that has been used in studies of post-treatment Lyme disease syndrome. An FSS-11 score of ≥4.0 is indicative of severe fatigue.
Results |
A total of 100 subjects were assessed, 52% of whom were male; the mean age was 64.9 years (range, 42-86 years). The mean duration of follow-up was 15.4 years (range, 11-20 years). Nine subjects had severe fatigue but in none as a consequence of Lyme disease. Only 3 subjects were thought to possibly have persistent fatigue from Lyme disease. The FSS-11 value for these 3 individuals was less than 4, averaging 2.27, and none had functional impairment.
Conclusions |
Severe fatigue was found in 9 patients (9%) with culture-confirmed early Lyme disease at 11 to 20 years after presentation, but was due to causes other than Lyme disease. Fatigue of lesser severity was possibly due to Lyme disease, but was found in only 3% of 100 patients, and therefore is rarely a long-term complication of this infection.
Le texte complet de cet article est disponible en PDF.Keywords : Borrelia burgdorferi, Fatigue, Lyme disease, Post-Lyme disease symptoms
Plan
| Funding:RO1 CK 000152 from the Centers for Disease Control and Prevention to GPW. The findings and conclusions are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. |
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| Conflict of Interest: GPW reports receiving research grants from Immunetics, Inc, and bioMérieux SA; owns equity in Abbott; has been an expert witness in malpractice cases involving Lyme disease; is an unpaid board member of the American Lyme Disease Foundation; has been an expert witness regarding Lyme disease in a disciplinary action for the Missouri Board of Registration for the Healing Arts; and was a consultant to Baxter for Lyme disease vaccine development. RBN has received consulting fees from Guidepoint Global and Decision Resources and has been an expert witness in malpractice cases involving Lyme disease. |
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| Authorship: All authors had access to the data and played a role in writing this manuscript. |
Vol 128 - N° 2
P. 181-184 - février 2015 Retour au numéro
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