LYME BORRELIOSIS - AN OVERDIAGNOSED DISEASE

Ninety-nine patients who were referred to a clinic for infectious dise ases on suspicion of Lyme borreliosis and whose major symptoms were fa tigue, headache, myalgia and arthralgia were studied retrospectively t o find out if there was any difference in symptomatology between patie nts who were seropositive or seronegative to Borrelia burgdorferi. 64/ 82 (78%) patients remembered one or more tick bites during previous ye ars and 32/73 (43%) patients had a history of erythema migrans. Fatigu e, headache, myalgia and arthralgia occurred in 84%, 72%, 54%, and 63% of the patients, respectively. 62/99 (63%) patients had an elevated I gM and/or IgG antibody titer to B, burgdorferi. There was no differenc e in frequency of symptoms between seropositive and seronegative indiv iduals. 48/99 (49%) patients were treated with antibiotics, mostly ora l doxycycline. Only 50% were improved after treatment. On follow-up 2 to 4 years after the first visit, 40% of the patients had recovered co mpletely, 31% were improved, 24% reported unaltered symptoms and four patients were impaired, There was no difference in symptoms on follow- up between seropositive or seronegative patients. It is concluded that there probably is an overdiagnosis of Lyme borreliosis and that bette r microbiological methods are needed to confirm active disease.