Suspicion of Lyme borreliosis in patients referred to an infectious diseases clinic : what did the patients really have?

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Kortela , E , Kanerva , M , Kurkela , S , Oksi , J & Järvinen , A 2021 , ' Suspicion of Lyme borreliosis in patients referred to an infectious diseases clinic : what did the patients really have? ' , Clinical Microbiology and Infection , vol. 27 , no. 7 , pp. 1022-1028 . https://doi.org/10.1016/j.cmi.2020.09.022

Title: Suspicion of Lyme borreliosis in patients referred to an infectious diseases clinic : what did the patients really have?
Author: Kortela, Elisa; Kanerva, Mari; Kurkela, Satu; Oksi, Jarmo; Järvinen, Asko
Contributor organization: Infektiosairauksien yksikkö
HUS Inflammation Center
Medicum
Department of Virology
Olli Pekka Vapalahti / Principal Investigator
Viral Zoonosis Research Unit
HUSLAB
Department of Medicine
University of Helsinki
Date: 2021-07
Language: eng
Number of pages: 7
Belongs to series: Clinical Microbiology and Infection
ISSN: 1198-743X
DOI: https://doi.org/10.1016/j.cmi.2020.09.022
URI: http://hdl.handle.net/10138/345954
Abstract: Objective: To evaluate the conditions behind the symptoms in patients with suspected Lyme borreliosis (LB) who were referred to an infectious diseases clinic. Methods: In this retrospective, population-based study, we collected data from the medical records of all patients referred for infectious disease consultations in 2013 due to presumed LB from a population of 1.58 million. The patients were classified according to the certainty of LB on the basis of their symptoms, signs and laboratory results. Data on the outcomes and subsequent alternative diagnoses during the 4-year follow-up period were reviewed from all of the available patient records from public, private and occupational healthcare providers. Results: A total of 256 patients (16/100 000) were referred as a result of suspicion of LB; 30 (12%) of 256 were classified with definite, 36 (14%) with probable and 65 (25%) with possible LB. LB was unlikely in 121 (47%) patients. A novel diagnosis was discovered in the background symptoms in 73 (29%) of pa-tients. Previously diagnosed comorbidities caused at least some of the symptoms in 48 (19%) patients. Other explanations for symptoms were found in 81 (67%) of 121 of unlikely and 22 (34%) of 65 of possible LB patients. The spectrum of conditions behind the symptoms was quite broad and most often were musculoskeletal, neurological, psychological or functional disorders. Conclusions: LB was unlikely in half of the patients with presumed LB. In most cases the patients had other conditions that explained their symptoms. Elisa Kortela, Clin Microbiol Infect 2021;27:1022 (c) 2020 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
Subject: Borrelia burgdorferi
Differential diagnosis
Finland
Lyme borreliosis
Lyme disease
DIAGNOSIS
NEUROBORRELIOSIS
3121 General medicine, internal medicine and other clinical medicine
11832 Microbiology and virology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: draft


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