Clinical StudiesFatigue in patients with erythema migrans
Section snippets
Methods
Adult patients with Lyme disease were enrolled between 2011 and 2015 in a prospective study to assess outcomes. Exclusion criteria included: a history of Lyme disease within 12 months or ongoing symptoms from a more remote bout of Lyme disease; pregnancy or being postpartum; an immunocompromising condition; having a diagnosis of fibromyalgia, chronic fatigue syndrome, or traumatic brain injury; any prolonged history of undiagnosed or unexplained somatic complaints; and any underlying disease or
Results
Fifty-one adult patients with untreated erythema migrans were evaluated in this study. The mean age was 49.8 years (range, 20–86 years), and 33 (64.7%) were male (Table 1). Twenty-one (41.2%) had multiple erythema migrans skin lesions. The mean duration ± SD of the erythema migrans skin lesion was 7.88 ± 5.51 days (median, 7 days; range, 1–22 days) (patients who presented on the same day as the skin lesion was discovered were regarded as having a duration of 1 day in this analysis).
All 3 measures of
Discussion
Fifty-one adult patients with erythema migrans were assessed by 3 different measures of fatigue. An 8-cm VAS assessed the presence and severity of fatigue on the day of the visit. The FSS-11 assessed the severity of fatigue over the prior 14 days. What we have termed the “28d-FS” determined the frequency that fatigue was experienced over a 28-day time frame.
Based on a positive score on the VAS, 26 (50.1%) had fatigue on the day of study entry. Based on the FSS-11, 10 (19.6%) of the enrolled
Funding
RO1 CK 000152 from the Centers for Disease Control and Prevention (CDC) to GPW. This publication was also made possible by support from CTSA grant numbers UL1 TR000142 and KL2 TR000140 from the National Center for Advancing Translational Science, components of the National Institutes of Health (NIH), and NIH roadmap for Medical Research to EDS. The findings and conclusions of this paper are those of the authors and do not necessarily represent the official position of the CDC or the NIH.
Disclosures
Dr Wormser reports receiving research grants from Immunetics, Institute for Systems Biology, Rarecyte, and Quidel Corporation. He owns equity in Abbott; has been an expert witness in malpractice cases involving Lyme disease; and is an unpaid board member of the American Lyme Disease Foundation. Dr Shapiro has received royalty payments from UptoDate; has been an expert witness in malpractice cases involving Lyme disease; and is an unpaid board member of the American Lyme Disease Foundation.
Acknowledgments
The authors thank Denise Cooper, Julia Singer, Sophia Less, Artemio Zavalla, and Lisa Giarratano for their assistance.
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