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Lyme Disease Presenting as Chronic Fatigue Syndrome – Source: Journal of Chronic Fatigue Syndrome, Vol 3 #4, 2007

by Samuel Shor, MD, FACP
October 10, 2007

Objective: Chronic Fatigue Syndrome (CFS) by definition represents a diagnosis of exclusion. Late stage or "Chronic Lyme" infection with or without "co-infections" is a difficult diagnosis to establish. The symptom complex of both conditions can be very similar. This case study represents an attempt to support serious consideration for a subpopulation of patients otherwise diagnosed with "CFS," as actually representing chronic Lyme disease.

Method: A case study is presented of a 33-year-old man, who for two years was being managed as having CFS. However, after ~2 years of utilizing multiple modalities of management with limited success, the diagnosis of Lyme was reconsidered.

Historical exposure risks to Lyme in this individual were high. He had prolonged exposure in the highly tick-infested mountains of North Carolina for 18 months, several years prior to becoming ill. More aggressive investigation confirmed the diagnosis of Lyme.

Appropriate changes in management were associated with an improved level of functioning that was far in excess of what maximal management of CFS was able to achieve.

The features of CFS and chronic Lyme can be very similar and include the following: Profound fatigue often associated with cognitive impairment. Other common symptoms related to both of these conditions include sleep disturbances, Fibromyalgia, and dysautonomias.

In pursuing clarification of this diagnosis, the author was exposed to a contrast in medical opinion regarding diagnostic tools and criteria that were perceived as creating potential barriers to the management of patients presenting with these symptoms.

Conclusion: Acceptance and awareness of the possibility that Lyme disease can present as CFS has important therapeutic and prognostic implications.

Source: Journal of Chronic Fatigue Syndrome. 2007 Vol 13 Issue 4 pp: 67-75. DOI: 10.1300/J092v13n04_06, by Samuel Shor, MD, FACP, Associate Clinical Professor, George Washington University Health Care Sciences, Reston, Virginia, USA. [E-mail: sshor@intmednova.com]



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Lyme disease presenting as CFS
Posted by: isycxqlp
Oct 10, 2007
This is an article I would like to read in full. I think it should be titled as Chronic Fatigue Syndrome misdiagnosed as Lyme disease. That appears to be a better description of what has occured from the brief bit I have read. Keep plugging away with the research. I appreciate it. Rick
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Lyme is the great imitator!
Posted by: munch1958
Oct 11, 2007
Since Lyme Disease testing is so poor, I think it's important for everyone with CF/FM to be screened for Lyme disease. The diagnosis of Lyme is a clinical one to be made by a Lyme Literate Medical Doctor. There are many reasons why tests can be negative even though Lyme bacteria is present. I thought I had CF since 1981 and FM since 1997. Last year I found out that I have Lyme Disease. I've been on long term antibiotics with great improvement per the Roadback.org protocol. I've made a slow and steady recovery. How do we read the full article on this?
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