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  lüll Chronic Lyme disease: a review Marques AInfect Dis Clin North Am  2008[Jun]; 22 (2): 341-60, vii-viiiStudies have shown that most patients diagnosed with chronic Lyme disease either  have no objective evidence of previous or current infection with Borrelia  burgdorferi or are patients who should be classified as having post-Lyme disease  syndrome, which is defined as continuing or relapsing nonspecific symptoms (such  as fatigue, musculoskeletal pain, and cognitive complaints) in a patient  previously treated for Lyme disease. Despite extensive study, there is currently  no clear evidence that post-Lyme disease syndrome is caused by persistent  infection with B burgdorferi. Four randomized placebo-controlled studies have  shown that antibiotic therapy offers no sustained benefit to patients who have  post-Lyme disease syndrome. These studies also showed a substantial placebo  effect and a significant risk of treatment-related adverse events. Further  research to elucidate the mechanisms underlying persistent symptoms after Lyme  disease and controlled trials of new approaches to the treatment and management  of these patients are needed.|*Lyme Disease/diagnosis/drug therapy[MESH]|Anti-Bacterial Agents/therapeutic use[MESH]|Chronic Disease[MESH]|Humans[MESH]|Syndrome[MESH] |