Lyme disease consultations common in France
Concerned about the over diagnosis of Lyme disease in France, Haddad and colleagues respond to a recent article discussing the treatment of 478 patients consulted for presumed Lyme borreliosis (LB) at a center in Nancy, France. In a Letter to the Editor, Haddad includes two other French studies and reports on their results. 
by Daniel J. Cameron, MD, MPH
According to Haddad, more than 1,000 individuals consulted 1 of 3 centers in France about presumed Lyme borreliosis. However, the majority (90%) were not diagnosed with Lyme disease. “The most striking result is that approximately 10% of such patients have a ﬁnal diagnosis of LB [Lyme borreliosis],” writes Haddad.
Yet, in one of the studies reviewed, most of the patients (85%) were treated with antibiotics for LB. This, the authors point out, is concerning as there appears to be an over diagnosis of Lyme borreliosis in France. And in turn, an over treatment with antibiotics, as well as anti-parasitic, anti-fungal, and antiviral drugs.
Haddad points out that these patients also qualify for a broad range of diagnoses including fibromyalgia, burn-out syndrome, post-traumatic stress disorder, moral harassment, sexual harassment, and depression.
Editor’s Note: These diagnoses are not clear cut. Therefore, it’s particularly important for clinicians to follow-up with patients to be sure the illness hasn’t progressed and led to Lyme disease, after all.
- Haddad E, Caumes E. Experience of three French centers in the management of more than 1,000 patients consulting for presumed Lyme Borreliosis. Med Mal Infect. 2019.