Where does this leave patients who are living with symptoms possibly related to Lyme disease, and where does this lead their clinicians? The report by Berende et al. is an important contribution and contains a simple message, regardless of the diagnosis given to those enrolled in the trial. Patients with subjective, vexing symptoms attributed to Lyme disease should not anticipate that even longer courses of antibiotics will produce relief, a finding that is in concert with results from previous trials. These patients may, however, take small comfort in a recent study of longer-term outcomes after culture-confirmed Lyme disease that showed that mental and physical health scores had returned to baseline scores similar to those of the age-adjusted U.S. population.


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