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Of the 788 patients,180(23%)had active Lyme disease,usually arthritis, encephalopathy,or polyneuropathy.One hundred fifty-six patients(20%)had previous Lyme disease and another current illness,most commonly chronic fatigue syndrome or fibromyalgia;and in 49 patients,these symptoms began soon after objective manifestations of Lyme disease.The remaining 452 patients(57%)did not have Lyme disease.The majority of these patients also had the chronic fatigue syndrome or fibromyalgia;the others usually had rheumatic or neurological diseases.Of the patients who did have Lyme disease,45%had had positive serological test results for Lyme disease in other laboratories,but all were seronegative in our laboratory.Prior to referral,409 of the 788 patients had been treated with antibiotic therapy. In 322(79%)of these patients,the reason for lack of response was incorrect diagnosis.Only a minority of the patients referred to the clinic met diagnostic criteria for Lyme disease.The most common reason for lack of response to antibiotic therapy was misdiagnosis. |
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