At any given time thousands of people feel unwell and are dissatisfied with the diagnoses offered them by their doctors.  They struggle to understand their illness and frequently form patient groups for mutual support.  Every few years a new diagnosis captures their attention and becomes the latest vogue illness, usually without any scientific evidence.  Even worse, unscrupulous doctors latch on to these fad diagnoses to promise cures to patients who are desperate for relief.  A few years ago the fringe diagnosis du jour was chronic Epstein-Barr virus infection.  Then it was systemic Candida infection.  Now it’s chronic Lyme disease.

This week’s New England Journal of Medicine has a very helpful review article on the phenomenon of chronic Lyme disease.  The important point is that while Lyme disease is a well described and understood entity, chronic Lyme disease is a diagnosis that has never been substantiated despite careful attempts to study it.  It is an entity that is either self-diagnosed by patients or offered by physicians whose practice is, um, let’s say not evidence-based.  The patients are offered long term antibiotics for their symptoms, despite the multiple trials showing that this treatment is no more effective than placebo, and has all the potentially serious side effects of antibiotic therapy.

The entire article is available free even if you don’t subscribe.  If you know someone who is being treated with long term antibiotics for chronic Lyme disease you owe it to them to send them a link to the article.

Tangential Miscellany:

Fall is here.  Get your flu shots.