ArticleOpen forum infectious diseases2019
Misdiagnosis of Lyme Disease With Unnecessary Antimicrobial Treatment Characterizes Patients Referred to an Academic Infectious Diseases Clinic.
Article in Open forum infectious diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Guidelines for diagnosis and treatment in neurology - Lyme neuroborreliosis.German medical science : GMS e-journal · 2025Guideline
- Diagnosis and treatment of "chronic Lyme": primum non nocere.BMC infectious diseases · 2023Pooled it
- The use of artificial intelligence in assessing fever in the returning traveller: A scoping review.PLOS digital health · 2026Article
- The Journey of Adult Patients with Lyme Disease in the United States: A Qualitative Interview Study and Patient-Reported, Health-Related Quality-of-Life Assessment.Advances in therapy · 2026Article
- Lyme borreliosis.Nature reviews. Disease primers · 2026Review
- Can the epidemiology of zoonotic disease be studied in routine health records? A feasibility study of the Clinical Practice Research Datalink (CPRD).One health (Amsterdam, Netherlands) · 2025Article
- Atypical presentation of Lyme disease in a returning traveler: a case report.Tropical diseases, travel medicine and vaccines · 2025Article
- Histological staining of tick bite skin biopsies for spirochetes and Powassan virus RNA.Microbiology spectrum · 2025Article
- Epidemiology of Lyme Disease Diagnoses among Older Adults, United States, 2016-2019Emerging infectious diseases · 2024Article
- Evaluation and 1-year follow-up of patients presenting at a Lyme borreliosis expertise centre: a prospective cohort study with validated questionnaires.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- Neuropsychiatric Manifestations and Cognitive Decline in Patients With Long-Standing Lyme Disease: A Scoping Review.Cureus · 2024Article
- Scrutinizing Clinical Biomarkers in a Large Cohort of Patients with Lyme Disease and Other Tick-Borne Infections.Microorganisms · 2024Article
- Mapping the distribution of Lyme disease at a mid-Atlantic site in the United States using electronic health data.PloS one · 2024Article
- Immunoblot Criteria for Diagnosis of Lyme Disease: A Comparison of CDC Criteria to Alternative Interpretive Approaches.Pathogens (Basel, Switzerland) · 2023Article
- Persistent Symptoms After Treatment of Lyme Disease.Infectious disease clinics of North America · 2022Review
- Destroying the Village in Order to Save It: Collateral Damage in the Battle Over Lyme Disease.Open forum infectious diseases · 2022Article
- A Review of Post-treatment Lyme Disease Syndrome and Chronic Lyme Disease for the Practicing Immunologist.Clinical reviews in allergy & immunology · 2022Review
- Experience and knowledge of Lyme disease: A scoping review of patient-provider communication.Ticks and tick-borne diseases · 2021Article
- Estimating the Frequency of Lyme Disease Diagnoses, United States, 2010-2018.Emerging infectious diseases · 2021Article
- Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010-2018.Emerging infectious diseases · 2021Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough Lyme disease is the most common vector-borne infection in the United States, diagnostic accuracy within community settings is not well characterized.
methodsA retrospective observational cohort study of patients referred to an academic center with a presumed diagnosis or concern for Lyme disease between 2000 and 2013 was performed to analyze diagnoses and treatments. Characteristics of those with Lyme disease and those misdiagnosed as having Lyme disease were compared.
resultsOf 1261 patients, 911 (72.2%) did not have Lyme disease, 184 (14.6%) had active or recent Lyme disease, 150 (11.9%) had a remote history of Lyme disease, and 16 (1.3%) were identified as having possible Lyme disease. Patients without current Lyme disease were more likely to be female (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.08-2.45), to have had symptoms for >3 months (OR, 8.78; 95% CI, 5.87-13.1), to have higher symptom counts (OR per additional symptom, 1.08; 95% CI, 1.02-1.13), to have had more Lyme-related laboratory testing (OR per additional laboratory test, 1.17; 95% CI, 1.03-1.32), and to have been diagnosed with what were regarded as coinfections (OR, 3.13; 95% CI, 1.14-8.57). Of the 911 patients without Lyme disease, 764 (83.9%) had received antimicrobials to treat Lyme disease or their coinfections. The percentage of patients established to have Lyme disease was lower than in earlier studies of referred populations.
conclusionsAmong patients referred to an academic Infectious Diseases practice for Lyme disease, incorrect diagnoses and unnecessary antibiotic treatment were common, both for Lyme disease and for coinfections.
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