Stupica D, et al. - Researchers performed this prospective cohort study from June 1, 2010 to October 31, 2015 at the University Medical Center Ljubljana, Slovenia to examine the potential differences in clinical course and treatment outcome between patients with multiple erythema migrans (MEM) and patients with solitary erythema migrans (EM). Irrespective of dissemination, the long-term outcome at 12 months after treatment was comparable. They recommended follow-up of at least 12 months after treatment.

Methods

• For this investigation, researchers analyzed data from June 1, 2017 to January 3, 2018.
• Out of 778 consecutive adult patients with early Lyme borreliosis assessed, 200 patients with MEM and 403 patients with solitary EM were involved.
• They asked patients to refer a family member or a friend of similar age (±5 years) without a history of Lyme borreliosis to serve as a control participant.
• After that, they compared clinical course and posttreatment outcome of MEM with those of solitary EM.
• They evaluated outcome at 14 days and at 2, 6, and 12 months after enrollment.
• Patients completed a written questionnaire about their symptoms and controls completed the same questionnaire at each visit.

Results

• As per data, 200 subjects with MEM and 403 subjects with solitary EM were involved.
• It was noted that 94 (47.0%) were males and 106 (53.0%) were females, with a median (interquartile range [IQR]) age of 47 (35-58) years among the 200 patients with MEM.
• They found that 182 (45.2%) were males and 221 (54.8%) were females, with a median (IQR) age of 55 (42-62) years among the 403 patients with solitary EM.
• As compared to patients with solitary EM (93 [46.5%]; 95% CI, 39.4-53.7 vs 96 [23.8%]; 95% CI, 19.7-28.3; P < .001), patients with MEM reported Lyme borreliosis–associated constitutional symptoms at enrollment more often.
• They observed that the proportion of patients with incomplete response was higher in the MEM group than in the solitary EM group (14 days: 62 of 193 [32.1%] vs 72 of 391 [18.4%]; P < .001; 2 months: 38 of 193 [19.7%] vs 55 of 394 [14.0%]; P=.28; 6 months: 29 of 182 [15.9%] vs 31 of 359 [8.6%]; P=.02) during the initial 6 months after treatment.
• At the 12-month visit, the outcome was comparable: 10 of 170 (5.9%) patients with MEM vs 20 of 308 (6.5%) patients with solitary EM displayed incomplete response (-0.6; 95% CI, -5.5 to 4.3; P=.95).
• The present data indicated that the frequency of nonspecific symptoms in patients was similar to that in controls.