ArticleThe American journal of tropical medicine and hygiene2023
Initial Presentation and Time to Treatment in Early Lyme Disease.
Article in The American journal of tropical medicine and hygiene, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 9 citations in OpenAlex.
- Epidemiology of Lyme disease, a growing tick-borne disease of concern, in Japan from May 2013 to March 2024: a descriptive study.IJID regions · 2026Article
- Sex and menopause-based differences in presentation of early Lyme disease: A prospective cohort study.Clinical and experimental medicine · 2026Article
- Borreliosis and Other Tick-Borne Diseases in the Northern and Southern Hemispheres.Microorganisms · 2025Article
- Article
- Current and emerging approaches for eliminatingFrontiers in microbiology · 2024Review
- Can protection motivation theory predict protective behavior against ticks?BMC public health · 2023Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 1 country.
Funding
Abstract
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, P = 0.019), were more likely to have seen or removed a tick (P = 0.048) and to be non-Hispanic White (P = 0.025), and were less likely to present with disseminated lesions at the time of diagnosis (P = 0.003) than "Symptoms First" participants (104/271, 38.4%). In multivariate analyses, EM First participants had a 22% decrease in time to treatment (P = 0.012) 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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Registered trials
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