Factors contributing to adverse effects of therapy:
(1) misdiagnosis
(2) adverse effects of unnecessary therapy
(3) complications of prolonged exposure to antibiotics and/or corticosteroids
(4) exposure to potentially toxic therapies including herbal or alternative medicines
(5) failure to treat the actual underlying problem
(6) complications of therapeutic administration (injection site, central line infection, etc or other chronic, long-term parenteral access)
Risk factors for misdiagnosis include:
(1) self-diagnosis by the patient
(2) diagnosis by a clinician with no expertise in chronic Lyme disease
(3) lack of objective findings to support a diagnosis of Lyme disease
Complications of prolonged antibiotic therapy may include:
(1) Clostridium difficile colitis
(2) colonization with resistant organisms
(3) organ toxicity (hepatitis, nephrotoxicity, ototoxicity etc
(4) yeast or other infections associated with changes in normal flora
