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Treatment of the early manifestations of Lyme disease

Steere AC, Hutchinson GJ, Rahn DW +4 more1983Annals of Internal MedicineJournal Article
10.7326/0003-4819-99-1-22PubMed
CardiovascularMusculoskeletalNeurological
Lyme & Co-Infections

Abstract

During 1980 and 1981, we compared antibiotic regimens in 108 adult patients with early Lyme disease. Erythema chronicum migrans and its associated symptoms resolved faster in penicillin- or tetracycline-treated patients than in those given erythromycin (mean duration, 5.4 and 5.7 versus 9.2 days, F = 3.38, p less than 0.05). None of 39 patients given tetracycline developed major late complications (meningoencephalitis, myocarditis, or recurrent attacks of arthritis) compared with 3 of 40 penicillin-treated patients and 4 of 29 given erythromycin (chi square with 2 degrees of freedom = 5.33, p = 0.07). In 1982, all 49 adult patients were given tetracycline; again, none of them developed major complications. However, with all three antibiotic agents nearly half of the patients had minor late symptoms such as headache, musculoskeletal pain, and lethargy. These complications correlated significantly with the initial severity of illness. For patients with early Lyme disease, tetracycline appears to be the most effective drug, then penicillin, and finally erythromycin.

Symptom Clusters

Erythema chronicum migransHeadacheLethargyMeningoencephalitisMusculoskeletal painMyocarditisRecurrent arthritis

Cited By (27)

  • The early clinical manifestations of Lyme diseaseAnnals of Internal Medicine · 1983
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  • Antibody response in Lyme disease: Evaluation of diagnostic testsThe Journal of Infectious Diseases · 1984
  • Invasion of the central nervous system by Borrelia burgdorferi in acute disseminated infectionJAMA · 1992
  • Chronic Lyme disease: a reviewInfectious Disease Clinics of North America · 2008
  • Neurologic abnormalities in Lyme disease without erythema chronicum migransThe American Journal of Medicine · 1986
  • Persistence of Immunoglobulin M or Immunoglobulin G Antibody Responses toBorrelia burgdorferi10–20 Years after Active Lyme DiseaseClinical Infectious Diseases · 2001

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  • References (3)

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