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Implications of gender in chronic Lyme disease.

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Lyme disease syndrome" refers to prolonged subjective symptoms after antibiotic treatment and resolution of an objective manifestation of Borrelia burgdorferi infection (
Lyme disease). "Chronic
Lyme disease" is a vaguely defined term that has been applied to patients with unexplained prolonged subjective symptoms, whether or not there was or is evidence of B. burgdorferi infection.


To determine if the population of patients with chronic
Lyme disease differs from the populations of patients with either
Lyme disease or post-
Lyme disease syndrome by examining the gender of patients with these diagnoses.


Data on gender were compiled in this cross-sectional study based on a systematic review of published studies of antibiotic treatment in United States patients with post-
Lyme disease syndrome (n = 184) or chronic
Lyme disease (n = 490), and on cases of adults with
Lyme disease reported to the Centers for
Disease Control and Prevention from 2003 to 2005 (n = 43,282).


Patients with chronic
Lyme disease were significantly more likely to be female than were patients diagnosed with either
Lyme disease (odds ratio [OR] 2.42, 95% confidence interval [CI] 1.98-2.94, p < 0.0001) or with post-
Lyme disease syndrome (OR 2.32, 95% CI 1.62-3.34, p < 0.0001).


Patients with chronic
Lyme disease differ with regard to gender from those with either B. burgdorferi infection or post-
Lyme disease syndrome. This finding suggests that illnesses with a female preponderance, such as fibromyalgia, chronic fatigue syndrome, or depression, may be misdiagnosed as chronic
Lyme disease.

J Womens Health (Larchmt). 2009 Jun;18(6):831-4. doi: 10.1089/jwh.2008.1193. Research Support, N.I.H., Extramural

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