Misdiagnosed Lyme: A Multidisciplinary Case Series from a Non- Endemic Region

Lyme disease, caused by the spirochete Borrelia burgdorferi and transmitted through Ixodes tick bites, is the most prevalent vectorborne illness in North America and Europe.Early manifestations include erythema migrans and flu-like symptoms, which typically respond well to antibiotics. 1 However, non-specific symptoms such as fatigue and musculoskeletal pain often create diagnostic uncertainty and contribute to overdiagnosis. 2 Many patients referred for Lyme disease evaluation do not meet established diagnostic criteria and are ultimately found to have other medical or psychiatric conditions. 3verreliance on serologic testing, particularly in low-prevalence settings, may yield false positives and lead to inappropriate treatment. 4In addition, some clinicians overdiagnose Lyme disease, occasionally bordering on quackery or fraud.Such practices result in unsupported diagnoses, further fueling overdiagnosis 5 and posing significant diagnostic and therapeutic challenges. 6To illustrate this issue, we present a series of striking misdiagnosed cases from our clinical practice.