Fatigue in Patients with Erythema Migrans
Published Date:Jul 27 2016
Source:Diagn Microbiol Infect Dis. 86(3):322-326.
Pubmed Central ID:PMC5061607
Funding:KL2 TR000140/TR/NCATS NIH HHS/United States
R01 CK000152/CK/NCEZID CDC HHS/United States
UL1 TR000142/TR/NCATS NIH HHS/United States
UL1 TR001863/TR/NCATS NIH HHS/United States
Fatigue is a common symptom in patients with Lyme disease.
The purpose of this study was to characterize fatigue in untreated adult patients presenting with erythema migrans. Selected variables were assessed to determine if any correlated with the presence or severity of fatigue.
Fatigue was assessed on the day of the evaluation by a visual analogue scale (VAS), over the past 14 days by the 11-item fatigue severity scale (FSS-11) and over the past 28 days based on a question from the 36-item Short Form General Health Survey version 2.
51 patients with erythema migrans whose mean age was 49.8 years, and 33 (64.7%) of whom were male, were evaluated in this study. The three measures of fatigue were positively correlated with one another (p ≤ 0.01). 26 (51%) had fatigue based on a VAS score above 0. 10 (19.6%) had severe fatigue based on an FSS-11 score of ≥ 4. The strongest correlate for higher fatigue scores was having a greater number of symptoms in addition to fatigue.
Based on the FSS-11 assessment tool, approximately 20% of early Lyme patients have severe fatigue. Having a high total number of symptoms was associated with both the presence and severity of fatigue. Since prior studies have demonstrated the presence of elevated levels of pro-inflammatory cytokines and other molecules in the serum of highly symptomatic patients with erythema migrans, the symptom of fatigue in early Lyme disease may be a component of what has been referred to as the acute sickness response.
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