The article "The Lyme Disease Controversy: Social and Financial Costs of Misdiagnosis and Mismanagement," by Sigal,1 presents an interesting but incomplete discussion of the controversy and disagreements facing clinicians and patients in the diagnosis and treatment of Lyme disease. Many clinicians propose that there is a significant incidence of overdiagnosis and subsequent overtreatment of Lyme disease. This opinion was prominently set forth in a 1993 article, "The Overdiagnosis of Lyme Disease," by Steere et al.2 In their article, Steere and colleagues note that a significant portion of the patients who were referred to a Lyme disease clinic for difficult-to-treat or poorly responsive disease did not actually have Lyme disease but, instead, had one of a handful of other conditions that seemed to occasionally follow or be confused with Lyme disease. Lack of antibody positivity to the Lyme organism was a common factor excluding the diagnosis of Lyme disease.
McCaulley ME. The Costs of Lyme Disease. Arch Intern Med. 1997;157(7):817. doi:10.1001/archinte.1997.00440280167016