{"id":1248,"date":"2010-12-09T13:22:52","date_gmt":"2010-12-09T18:22:52","guid":{"rendered":"http:\/\/blogs.nejm.org\/?p=1248"},"modified":"2010-12-09T13:22:52","modified_gmt":"2010-12-09T18:22:52","slug":"chronic-lyme-tough-to-diagnose-tough-to-treat","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/chronic-lyme-tough-to-diagnose-tough-to-treat\/2010\/12\/09\/","title":{"rendered":"Chronic Lyme Tough to Diagnose, Tough to Treat"},"content":{"rendered":"

Over at the Chicago Tribune<\/em>, there is this superb review<\/a> of the Chronic Lyme disease issue.<\/p>\n

Lyme disease is real. The bacterial infection, chiefly transmitted by deer ticks, can cause rashes, swollen joints and inflamed nerves, and usually is curable with a round of antibiotics.<\/p>\n

But doctors around the country are telling patients with common medical problems such as back pain, poor concentration and fatigue that their ailments stem from a chronic form of Lyme disease that can evade standard treatment and wreak havoc for years. To fight what they believe is a persistent infection, the doctors often order months or years of intravenous antibiotics, which can cost tens of thousands of dollars.<\/p>\n

Strong evidence isn’t on their side. \u00a0But in a golden age of dubious medicine, that doesn’t matter.<\/p><\/blockquote>\n

My advice: \u00a0read the full article<\/em>, as I cannot recall a better summary in the lay press of this highly-contentious topic.<\/p>\n

Oh, and for the record, in my experience there are few encounters more challenging in ID practice than addressing the diagnosis of “chronic Lyme.”<\/p>\n

Many patients given the diagnosis are (legitimately) so desperate to find an explanation for their suffering \u2014 and to do something rather than nothing \u2014 that they latch onto this unproven diagnosis and are willing to receive potentially harmful therapy rather than continue to live in misery without taking action.<\/p>\n

And when, as an ID doctor, you review all the history and data and find no evidence of Lyme, you make a person who feels sick feel even worse<\/em> \u2014 because usually there is no alternative infectious explanation for their various complaints.<\/p>\n

It’s an unbelievably difficult situation. \u00a0In many ways, chronic Lyme is even more difficult to treat than HIV \u2014 which was my original (jokey) title of this post, until someone told me it might be offensive. \u00a0But you get my point.<\/p>\n

So shared experiences, other thoughts, potential strategies for managing “chronic Lyme” \u2014 from my ID colleagues, from other providers, from patients \u2014 would be much appreciated.<\/p>\n","protected":false},"excerpt":{"rendered":"

Over at the Chicago Tribune, there is this superb review of the Chronic Lyme disease issue. Lyme disease is real. The bacterial infection, chiefly transmitted by deer ticks, can cause rashes, swollen joints and inflamed nerves, and usually is curable with a round of antibiotics. But doctors around the country are telling patients with common […]<\/p>\n","protected":false},"author":6,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,5,8,9],"tags":[72,184,423,577],"class_list":["post-1248","post","type-post","status-publish","format-standard","hentry","category-hiv","category-infectious-diseases","category-patient-care","category-policy","tag-antibiotics","tag-chronic-lyme","tag-hiv","tag-lyme-disease"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1248","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/comments?post=1248"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/posts\/1248\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/media?parent=1248"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/categories?post=1248"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/hiv-id-observations\/index.php\/wp-json\/wp\/v2\/tags?post=1248"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}