Misdiagnosis: Is it Chronic Lyme Disease or Something Else?

the MPR take:

A research letter published in JAMA Internal Medicine outlines three case studies of patients misdiagnosed with chronic Lyme disease, which delayed the diagnosis and treatment of their actual conditions. Christina Nelson, MD, from the Centers for Disease Control and Prevention (CDC) and colleagues state that chronic Lyme disease is a loosely defined diagnosis given to patients with a range of symptoms – including those with no objective evidence of the disease – from physicians who are not often experts in infectious diseases. Two of the patients described had no evidence of ever having Lyme disease but were prescribed antibiotics; one was eventually diagnosed with a pituitary tumor and elevated insulin-like growth factor consistent with acromegaly, and the other received a confirmed diagnosis of stage IV mucosa-associated lymphoid tissue lymphoma. The third patent tested positive for Lyme disease but when antibiotics did not improve his malaise and fatigue symptoms, he sought treatment from an infectious disease specialist. These symptoms were initially attributed to his chronic Lyme disease but were later linked to a stage I non-small cell adenocarcinoma diagnosis. The authors conclude that nonspecific symptoms like fatigue, joint pain, or abdominal pain that are often associated with chronic Lyme disease should also be considered for other diseases and conditions, such as cancer in these three patient case studies.

Chronic Lyme disease is a loosely defined diagnosis given by a small number of physicians—who are not usually infectious disease experts—to patients with various nonspecific symptoms, including patients with no objective evidence of Lyme disease.