Lyme Literate Doctor: What Does It Really Take?
So, what does it take to be a Lyme literate doctor?
The term is often used—sometimes dismissively—yet rarely defined with clinical precision.
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argues that “Lyme disease conforms to the same fundamental rules and principles applicable
to other infectious diseases.”
However, Baker does not define what it would actually take for a board-certified infectious
disease specialist to be considered “Lyme literate,” particularly when patients present
with complex, multisystem illness.
Defining a Lyme Literate Doctor
At a minimum, a Lyme literate doctor should be able to recognize, diagnose, and manage
Lyme disease across its full clinical spectrum—not just early infection or classic
presentations.
A truly Lyme literate clinician should be comfortable evaluating and treating patients
with the following conditions:
Clinical Conditions a Lyme Literate Doctor Should Recognize
- Lyme encephalopathy
- Lyme neuropathy
- Neuropsychiatric Lyme disease
- Pediatric neuropsychiatric disorders (PANS)
- Lyme carditis
- Autonomic dysfunction, including POTS
- Post-treatment Lyme fatigue and post-Lyme disease syndromes
- Neuropathic pain syndromes
- Persistent symptoms following Lyme disease
- Concurrent tick-borne co-infections
Why This Definition Matters
Many of these presentations are well documented in the medical literature, yet they are
often minimized, reframed, or excluded from routine Lyme disease evaluations.
A Lyme literate doctor does not abandon evidence-based medicine. Instead, they recognize
the limitations of current diagnostics, the variability of immune response, and the
biological plausibility of persistent or relapsing illness in a subset of patients.
Lyme literacy, therefore, is not about ideology—it is about clinical breadth, intellectual
humility, and the willingness to engage diagnostic uncertainty without prematurely
dismissing patients.
References:
- Baker PJ. Is It Possible to Make a Correct Diagnosis of Lyme Disease on Symptoms Alone?
Review of Key Issues and Public Health Implications.
Am J Med. 2019. - Logigian EL, Kaplan RF, Steere AC. Chronic neurologic manifestations of Lyme disease.
N Engl J Med. 1990;323(21):1438–1444. - Fallon BA, Nields JA. Lyme disease: a neuropsychiatric illness.
Am J Psychiatry. 1994;151(11):1571–1583. - Sigra S, Hesselmark E, Bejerot S. Treatment of PANDAS and PANS: a systematic review.
Neurosci Biobehav Rev. 2018;86:51–65. - Muehlenbachs A, Bollweg BC, Schulz TJ, et al.
Cardiac tropism of Borrelia burgdorferi.
Am J Pathol. 2016. - Kanjwal K, Karabin B, Kanjwal Y, Grubb BP.
Postural orthostatic tachycardia syndrome following Lyme disease.
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Study and treatment of post Lyme disease (STOP-LD).
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Fear of pain in children and adolescents with neuropathic pain.
Pain. 2016;157(Suppl 1):S90–S97. - Klempner MS, Hu LT, Evans J, et al.
Two controlled trials of antibiotic treatment in patients with persistent symptoms.
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