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Nelson C, Elmendorf S, Mead P. Neoplasms Misdiagnosed as “Chronic Lyme Disease”. JAMA Intern Med. 2015;175(1):132–133. doi:10.1001/jamainternmed.2014.5426
Clinical features of Lyme disease include erythema migrans rash, facial palsy, arthritis, and peripheral neuropathy. In endemic areas, patients with erythema migrans can be diagnosed clinically. Otherwise, diagnosis is based on the history of possible exposure, compatible clinical features, and positive 2-tier serologic testing.1
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.2 In addition to adverse outcomes from unconventional treatments for chronic Lyme disease,3,4 patients misdiagnosed with chronic Lyme disease may be harmed when their actual condition remains untreated.
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