Neoplasms Misdiagnosed as “Chronic Lyme Disease” | Endocrinology | JAMA Internal Medicine | JAMA Network
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    1 Comment for this article
    Misdiagnosis not necessarily demonstrated
    Ed Auersperg | UBC
    I should start by stating that I, like the vast majority of physicians, believe that current evidence strongly suggests that \"chronic Lyme disease\" after appropriate therapy is vanishingly rare, if it exists at all.However, these three case reports do not necessarily demonstrate misdiagnosis. The third case in particular leaves open at least the theoretical possibility that the patients may have had \"chronic Lyme\" in addition to a neoplasm. It would therefore be useful to learn whether symptoms disappeared after treatment.
    CONFLICT OF INTEREST: None Reported
    Research Letter
    January 2015

    Neoplasms Misdiagnosed as “Chronic Lyme Disease”

    Author Affiliations
    • 1Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
    • 2Upstate Infectious Disease Associates, Albany, New York
    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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