|
|
|
|
Of the 15 patients,9 developed widespread musculoskeletal pain,tender joints,dysesthesias,memory difficulties,and debilitating fatigue a mean duration of 1.7 months after early Lyme disease;the remaining six patients developed those symptoms during the course of Lyme arthritis.At the time of our evaluation,late in the course of their illness,11 patients had positive immunoglobulin(lg)G antibody responses to Borrelia bergdorferi by enzyme-linked immmunosorbent assay(LISA),one had a positive Western blot, and the three seronegative patients had positive cellular immune responses to borrelia antigens.Four patients had abnormal cerebrospinal fluid analyses that showed an elevated protein level,a slight pleocytosis,or intrathecal antibody production to the spirocyte.The signs of Lyme disease resolved with antibiotic therapy,usually intravenous ceftriaxone,2 g/d for 2 to 4 weeks,except in one patient with persistent knee swelling.However, 14 of the 15 patients continued to have symptoms of fibromyalgia. Currently,only one patient is completely asymptomatic.Lyme disease may trigger fibromyalgia,but antibiotics do not seem to be effective in the treatment of the fibromyalgia. |
|