Commentary: 'What's in a name? That which we call a rose by any other name would smell as sweet.' Shakespeare W. Romeo and Juliet, II, ii(47-48).

摘要

The term 'syndrome' (from the Greek 'concurrence': a set of symptoms that occur together; the sum of signs of any morbid state) suggests, to many that a collection of findings representsa disease sui generis. And so it is that 'post-Lyme disease (borreliosis) syndrome (PLDS)' a collection of non-specific symptoms/ including fatigue, achiness, and cognitive dysfunction, with a marked paucity of objective clinical findings has taken on an identity, a life of its own in the USA and perhaps elsewhere. Of note, there are no unique, diagnostic, or even explicitly suggestive findings in PLDS; in fart, there are no objective clinical findings. In the hands of certain individuals, be they physicians or patients, such symptoms may be ascribed to 'chronic Lyme disease (CLD)'-a chronic infection-based on little or no objective evidence of organ damage/dysfunction, evidence of ongoing infection, or even of proof of previous Borrelia burgdorferi infection. CLD is a purely hypothetical active, chronic, and refractoryinfection requiring extreme, in duration and intensity, antibiotic regimens, with untold consequences, physical, emotional, and ecological. As each therapeutic venture offers, at best, transient response, patients often descend into despair, even depression.