Lyme Anxiety

To the Editor. —A patient was recently referred for evaluation of "Lyme disease unresponsive to therapy." This 55-year-old man first developed intermittent "bandlike" headaches 6 months prior to my evaluation. He also reported myalgia, low-grade fever, and generalized weakness, which resolved within several days. There was no history of a tick bite, rash, or travel to areas known to have a high incidence of Lyme disease. However, he had read that Lyme disease could cause similar symptoms and requested a blood test for antibodies againstBorrelia burgdorferi. Though this test was negative, he persuaded his physician to administer a course of doxycycline. He later noted recurrence of the headaches and underwent intravenous treatment with ceftriaxone, again for Lyme disease. By the time of my evaluation, he had undergone two more courses of parenteral therapy and two more of oral antibiotics prescribed by several different physicians because of recurrent headaches. Two