Mistaken Identity: Many Diagnoses are Frequently Misattributed to Lyme Disease

Area of Science:

• Medical Diagnostics
• Infectious Diseases
• Neurology

Background:

• Lyme disease is often overdiagnosed, yet the specific conditions misdiagnosed as Lyme disease are not well-described.
• Previous research indicates a high rate of Lyme disease overdiagnosis.

Purpose of the Study:

• To identify and describe the conditions that are misdiagnosed as Lyme disease.
• To evaluate patients referred for suspected Lyme disease who lacked evidence of Borrelia burgdorferi infection.

Main Methods:

• Retrospective observational cohort study of patients referred for Lyme disease evaluation.
• Analysis of clinical diagnoses, symptom duration, and attribution to new or pre-existing conditions.
• Data collected from a Mid-Atlantic academic center between 2000 and 2013.

Main Results:

• 84% of referred patients lacked evidence of active Lyme disease.
• 65% of these patients received alternative diagnoses, including anxiety/depression (21%), fibromyalgia (11%), and chronic fatigue syndrome (7%).
• Median symptom duration was 796 days, with some patients diagnosed with serious conditions like multiple sclerosis or malignancy.

Conclusions:

• Most patients with chronic symptoms referred for Lyme disease evaluation have other new or pre-existing conditions.
• Overdiagnosis of Lyme disease is suggested in this patient population.
• Comprehensive assessment for alternative diagnoses is crucial for patients presenting with chronic symptoms suggestive of Lyme disease.