WORMSER IS CONFUSED

AGAIN & AGAIN & AGAIN

Everyone's Asking Wormser...

First of all, Wormser, et. al. finds Lyme disease itself confusing and the Lyme tests too! Wormser also feels changes (for the better) that aren't in line with his way of thinking will confuse others.

He admits his own little invention- "Post Treatment Lyme Disease Syndrome" (PTLDS)- is confusing, and the signs and symptoms of persistent or chronic Lyme also confuse him. Not that anyone was not straight on this topic already, but, he warns chronic Lyme disease should not be confused with his 'imaginary' PTLDS.

Even though Wormser claims Lyme tests are accurate, he continues to say Lyme disease can be confused with other illnesses. If his tests are accurate how can this be?

Wormser appears to be confused about Western Blot bands on the Lyme tests- what the numbers mean. He is also confused about fungal infections being mistaken for Lyme.

He states the Lyme rash (EM) is distinctive and if you have one you have Lyme disease and should be treated. But, he also says the Lyme rash can be confused with other rashes. Huh?

Wormser is confused about the symptoms caused by multiple strains of Lyme disease and after much studying doesn't seem to know if STARI is one of them?

Wormser is SO confused that his latest "gem", written by himself and Hold The Mayo Clinic, actually has the word "confusing" in its title! Source

J Clin Microbiol. 2018 Sep 26. pii: JCM.01406-18. doi: 10.1128/JCM.01406-18. [Epub ahead of print]

Limitations and Confusing Aspects of Diagnostic Testing for Neurologic Lyme Disease in the United States.

Theel ES1, Aguero-Rosenfeld ME2, Pritt B1, Adem PV3, Wormser GP4.

Wormser has already published over 240 articles on Lyme disease. It's clear looking back that confusion in Wormser's World has been ongoing for a LONG time.

For example, Wormser's discredited 2006 IDSA Lyme disease guidelines uses the word "confused" and similar wording EIGHT TIMES! That's not real reassuring! When an author takes it upon himself to write medical guidelines for patients there should be no room for confusion!

But, then again, patients and knowledgable doctors aren't really following his IDSA guidelines, the insurers are! Has anyone ever heard of an insurance company that wasn't confused, especially around 'billing" time?

In contrast, and thankfully, the most recent 2014 Lyme disease guidelines (Cameron, Johnson, Maloney) are based on solid facts, not Wormser's confused state of mind and rocky opinions. Not once is the word "confused" found in the Cameron, et. al. 2014 guidelines.

When Wormser claims others are confused he's obviously has forgotten he appointed himself a Lyme guru or acedemic scholar on the topic So, whose fault would it be if anyone was confused about Lyme at this point- IF they truely are the ones who are confused?

The "confused" references are highlighted so you can skim through without having to read the "confusing" quotes in their entirety!

Wormser Quote- "Consequently, there is increasing confusion about what Lyme disease is, or is not, for both patients and healthcare practitioners."

Wormser- Those Who Want Published Information To Be Accurate Will Be Confused- "This change would be expected to cause even more confusion in the Lyme disease field and not benefit in any way clinicians, clinical microbiology laboratories, or patients."

More Quotes By Wormser & Friends

WORMSER QUOTE- "This area is further confused as PTLDS, or what has been referred to as ‘chronic Lyme disease’, has become a diagnosis for medically unexplained symptoms, even when patients have no evidence of past or present Lyme borreliosis182,183." Source

WORMSER QUOTE- "Importantly, the various post-infectious complications of Lyme borreliosis should not be confused with signs of persistent infection with B. burgdorferi, and prolonged antibiotic therapy has not been shown to be beneficial." Source

WORMSER QUOTE- "PTLDS should not be confused with “chronic Lyme disease”." Source

WORMSER QUOTE- "This, however, can be confused with other illnesses including southern tick−associated rash illness (STARI), an illness that lacks a defined etiological agent or laboratory diagnostic test, and is coprevalent with Lyme disease in portions of the eastern United States." Source

WORMSER QUOTE- "Although an EM lesion is a hallmark for Lyme disease, other types of skin lesions can be confused with EM" Source

WORMSER QUOTE- "Nevertheless, an overlap in clinical symptoms, including the development of an EM-like skin lesion, creates confusion and controversy for the clinical differentiation of STARI and Lyme disease" Source

WORMSER QUOTE- "These latter bands might be confused with the 18-kDa antigen included in the IgG criteria for IB interpretation." Source

WORMSER QUOTE- "Other skin lesions, however, such as tick-bite hypersensitivity reactions, STARI (southern tick associated rash illness), and certain cutaneous fungal infections, can be confused with EM." Source

WORMSER QUOTE- "Lyme disease typically presents with a skin lesion called erythema migrans (EM), which though often distinctive in appearance may be confused with cellulitis." Source

WORMSER QUOTE- "Other skin disorders, however, may be confused with EM." Source

The CDC Is Using Wormser's Word "Confused" Too.

QUOTE- "When evaluating testing options, providers and their patients might be confused by the distinction between Clinical Laboratory Improvement Amendments (CLIA) certification of laboratories and FDA clearance or approval of specific tests." Source

Halperin- also admits yes, he is "confused"!

QUOTE- "A great deal of confusion surrounds the diagnosis, clinical phenomenology, and treatment of Lyme borreliosis." Source

QUOTE- "Samples were obtained from 16 patients with CNS Borrelia burgdorferi infection, eight patients with Lyme encephalopathy (confusion without intra-CNS inflammation), and 45 controls." Source

Auwaerter's Quotes

QUOTE- "Those who have true Borrelia burgdorferi infection are relatively easily to determine; however, others may be well complicated by confusion regarding test result interpretation as well as competing ideas about Lyme disease from Internet sources or alternative practitioners who often use the term “chronic Lyme disease” or diagnose concomitant tick-borne coinfections. Source

QUOTE- "Much of this confusion arises from improper interpretation of serologic tests for Lyme disease, most notably, reliance on IgM immunoblots for symptoms of beyond 4 weeks’ duration despite admonition otherwise due to high rates of inaccuracy, or application of such testing in nonendemic regions where acquisition of true infection is improbable and therefore false positive findings are highly likely." Source

QUOTE- "Many patients are confused by the apparently polar sets of diagnostic and therapeutic advice voiced by most established professional societies as compared with those articulated by advocates of chronic Lyme disease." Source

QUOTE- "More commonly, it is associated with a febrile illness and can be confused with atypical Lyme disease (without a rash), ehrlichiosis, or anaplasmosis." Source

QUOTE- "Auwaerter said multiple sclerosis, Parkinson’s and fibromyalgia are just some of the conditions frequently confused with Lyme." Source

QUOTE- "It is not possible to draw firm conclusions on the relative efficacy of accepted antibiotic drug regimens for the treatment of LNB." Source

Dattwyler Quotes

QUOTE- "The question of how long to treat Borrelia burgdorferi infection is a topic that provokes confusion among a large number of physicians." Source

QUOTE- "One has to question why a reasonable physician would treat a patient this way and more importantly what has led to this confusion." Source

QUOTE- "The occurrence of positive serologies to B burgdorferi in the presence of other diseases can lead to diagnostic confusion." Source

QUOTE- "Despite these possible sources of confusion, the academic physicians believe that Lyme disease usually can be accurately diagnosed." Source

QUOTE- "And some diseases that might be confused for Lyme disease- such as early multiple sclerosis- have periods of remission." Source

Little Lantos Quotes

QUOTE- "For a medical consumer and for the physician unfamiliar with this subject, this volume of information can be confusing and difficult to navigate." Source

QUOTE- "THE CONFUSING TERMINOLOGY OF CHRONIC LYME DISEASE" Source

QUOTE- "The mere name “chronic Lyme disease” is in itself a source of confusion." Source

Stephen Dumler- Another One Who Is Confused

QUOTE- "Because of the shared tick vector and increased seroprevalence of HGE in patients with Lyme disease, there is some confusion about the identity of these infectious agents and the clinicopathologic spectrum of the disease." Source

Lenny Sigal- A Ball of Confusion

QUOTE- "Disagreement between the belief systems has led to confusion and anxiety, resulting in an alternative, but unproved, approach to management." Source

QUOTE- "Because of confusion over conflicting reports, anxiety related to vulnerability to disease, and sensationalized and inaccurate lay media coverage, a new syndrome, "chronic Lyme disease," has become established." Source

QUOTE- "We describe factors involved in the psychopathogenesis of chronic Lyme disease and focus on the confusion and insecurity these patients feel, which gives rise to an inability to adequately formulate and articulate their health concerns and to deal adequately with their medical needs, a state of disorganization termed aporia." Source

QUOTE- (Title)- "Misconceptions about Lyme disease: confusions hiding behind ill-chosen terminology." Source

QUOTE- "A quarter century after its initial description, a review of the terminology contributing to confusion about Lyme disease is needed." Source

IDSA LYME GUIDELINES

CONFUSION QUOTES

Source

QUOTE- "There is no well-accepted definition of post–Lyme disease syndrome. This has contributed to confusion and controversy and to a lack of firm data on its incidence, prevalence, and pathogenesis."

QUOTE- "Possible explanations for the higher proportion of arthritis cases in national reporting include reporting bias favoring the tabulation of seropositive Lyme disease cases, confusion between arthritis and arthralgia by the treating health care provider [203], and inaccuracy of Lyme disease diagnosis [203]."

QUOTE- "Lyme encephalomyelitis may be confused clinically with a first episode of relapsing-remitting multiple sclerosis or primary progressive multiple sclerosis, but appropriate CSF and serum studies for B. burgdorferi–specific antibody should differentiate between these entities in most instances [216–218]."

QUOTE- "Considerable confusion and controversy exist over the frequency and cause of this process and even over its existence."

QUOTE- "This was an important omission, because the appearance of cellular debris may be confused with spirochetes on microscopic examination of culture supernatants [304]."

QUOTE- "This has contributed to confusion and controversy and to a lack of firm data on its incidence, prevalence, and pathogenesis."

QUOTE- "Because Babesia species may be confused with malarial parasites on blood smear, confirmation of the diagnosis and identification of the specific babesial pathogen may require additional laboratory testing."

QUOTE- "Sigal, LH. Misconceptions about Lyme disease: confusions hiding behind ill-chosen terminology, Ann Intern Med , 2002 , vol. 136 (pg. 413- 9)"

Lucy Barnes

AfterTheBite@gmail.com

October 1, 2018