Nancy A. Shadick, MD, MPH; Charlotte B. Phillips, MPH; Oliver Sangha, MD, MPH; Eric L. Logigian, MD; Richard F. Kaplan, PhD; Elizabeth A. Wright, PhD; Anne H. Fossel; Karin Fossel, MA; Victor Berardi, BA; Robert A. Lew, PhD; Matthew H. Liang, MD, MPH
Acknowledgments: The authors thank Drs. Allen Steere and Jeffrey Katz for reviewing the manuscript, Ms. Mary Scamman for her help with manuscript preparation, and Ms. Cheryl Bartlett and the staff of the Nantucket Cottage Hospital for support and resources. They also thank the residents of Nantucket Island for their enthusiasm and their participation in the study.
Grant Support: In part by National Institutes of Health grant AR36308. Dr. Shadick is supported by an Arthritis Investigator Award from the Arthritis Foundation and by a National Institutes of Health Mentored Clinical Science Research Award (02033).
Requests for Reprints: Nancy A. Shadick, MD, MPH, Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, email@example.com.
Current Author Addresses: Dr. Shadick: Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.
Ms. Phillips, Dr. Wright, Ms. A. Fossel, Ms. K. Fossel, and Dr. Lew: Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.
Dr. Sangha: Bavarian Public Health Research Center Ludwig, Maximilians University Munich School of Medicine, Munich D-81549, Germany.
Dr. Logigian: University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642.
Dr. Kaplan: University of Connecticut Health Center, 263 Farmington Avenue, Farmington, CT 06030.
Mr. Berardi: IMUGEN, Inc., 220 Norwood Park South, Norwood, MA 02364.
Dr. Liang: R.B. Brigham Arthritis Center, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115.
Shadick NA, Phillips CB, Sangha O, Logigian EL, Kaplan RF, Wright EA, et al. Musculoskeletal and Neurologic Outcomes in Patients with Previously Treated Lyme Disease. Ann Intern Med. 1999;131:919-926. doi: 10.7326/0003-4819-131-12-199912210-00003
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Published: Ann Intern Med. 1999;131(12):919-926.
Lyme disease is a multisystem disorder of the skin, nervous system, heart, and joints (1-3) caused by tick-borne infection with Borrelia burgdorferi. Although the neurologic and musculoskeletal sequelae of Lyme disease are well described (4-10), their long-term clinical and functional effects in patients previously treated with antibiotics are not well understood. Several follow-up analyses demonstrated an increased prevalence of neurocognitive and musculoskeletal sequelae in persons with previous Lyme disease (4-7, 11), particularly those who had the infection for a longer period before receiving treatment (5, 11).
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