“THE GREAT IMITATOR”

“The Borrelia burgdorferi (Bb) spirochete is an evasive organism which can penetrate virtually any organ or system in the body, including the brain and central nervous system, joints, muscles and heart. Lyme disease symptoms may be similar to other medical conditions, making diagnosing a challenge.

For this reason, Lyme disease and syphilis have both been coined “the great imitator.”

Patients with Lyme disease have been incorrectly diagnosed with: multiple sclerosis (MS), fibromyalgia, chronic fatigue syndrome, autoimmune diseases including lupus and rheumatoid arthritis [1-7] , polymyalgia rheumatica, thyroid disease, psychiatric disorders, Lou Gehrig’s Disease (ALS)*, and Alzheimer’s*, among others.

Fatigue, insomnia, and myalgias (muscle aches) are seen in both Fibromyalgia and Lyme disease. Chronic Fatigue Syndrome symptoms are often seen in Lyme disease patients and include severe fatigue, impaired memory and concentration, sleep disturbance, myalgias, and arthralgias.

Steere et al. described Lyme disease cases that were misdiagnosed as Juvenile Rheumatoid Arthritis (JRA). [8]

Nowakowski and Feder reported cases misdiagnosed as cellulitis (bacterial skin infection often causing spreading redness). [9,10]

Plotkin described a 39-year-old male with a retropopliteal rash that progressed, within three weeks to Lyme disease, with a loss of consciousness and a complete heart block that required insertion of a transvenous cardiac pacemaker. [11]

Lyme disease has been mistaken for multiple sclerosis (MS). [12,13] In fact, one author estimated that 5% – 10% of patients presumed to have MS suffered from other conditions including Lyme disease. [14]

Three cases of neuroborreliosis were initially misdiagnosed as anterior ischemic optic neuropathy (sudden loss of vision due to interruption of blood flow to the front optic nerve) caused by giant cell arteritis.

Neuropsychiatric presentations, including depression, anxiety and rage, have been identified in both acute and chronic Lyme disease cases. [15]

Lyme disease has also been mistaken for polymyalgia rheumatica (inflammation that causes aching, stiffness, and flu-like symptoms) [16,17], sports related injuries [18], and common medical conditions such as sinusitis, Epstein-Barr syndrome, rotator cuff tear, meniscus tear, edema, cellulitis, and pericarditis. [19]”