Comparison of males versus females with culture-confirmed early Lyme disease at presentation and at 11-20 years after diagnosis.

Background: Lyme disease is the most common vector-borne infection in the United States with 300,000 estimated cases per year.

Objective: The purpose of this study was to compare the presenting clinical features and long-term outcome of males versus females with culture-confirmed early Lyme disease.

Methods: 174 males and 109 females with culture-confirmed erythema migrans were entered into a prospective study with follow-up visits scheduled at six months, 12 months and annually thereafter for up to 20 years.

Results: Males and females with early Lyme disease had a similar likelihood of having multiple erythema migrans skin lesions and had a similar number of additional subjective symptoms, such as fatigue, at study entry. Among the 71 males and 57 females able to be followed up for 11-20 years, there were no significant differences in baseline symptoms, rate of seroreactivity to Borrelia burgdorferi, or in frequency of post-treatment symptoms. Females, however, were significantly more likely than males to return for follow-up visits (P = 0.0003).

Conclusion: Males and females with culture-confirmed early Lyme disease had similar clinical features, rates of seropositivity, and long-term outcomes.