Clinical presentation of Lyme disease in patients living in Germany

Lyme disease presentation in man from Germany holding his hands over his face.
In their article, entitled “Neuropsychiatric and Psychological Symptoms in Patients with Lyme Disease: A Study of 252 Patients,” Hündersen and colleagues describe the clinical presentation, diagnostic process and treatment regimens for 252 Lyme disease patients. [1]

The authors collected data via an online questionnaire from 252 Lyme disease patients and a control group of 267 healthy individuals living in Germany to examine the clinical presentation, including neuropsychiatric and psychological symptoms.

The findings revealed that “Lyme disease can cause diverse psychological and neuropsychiatric symptoms. These include limitations in quality of life, sleep, attention, and memory, as well as depressive symptoms.

Time to diagnosis

The majority of the patients were diagnosed with Lyme disease based on ELISA (53.2%), Western blot (43.7%), and lymphocyte transformation test results (41.7%).

Out of the 252 participants, nearly half (45.5%) recalled an erythema migrans rash, while 74% recalled a tick bite “that possibly triggered Lyme disease.”

It took approximately 8 years to receive a diagnosis following the tick bite.

On average, patients visited almost 8 physicians to obtain a diagnosis.

It took approximately 8 years to receive a diagnosis following the tick bite.  Less than half (46%) received their diagnosis within the first 5 years after the onset of symptoms.


The majority of participants were not diagnosed with or tested for a co-infections.

“A total of 25% of the sample stated that they had (exactly one) co-infection,” the authors explain, while 15% reported having 2 co-infections.

“For patients that suffered from co-infections, Chlamydia infection was particularly common (34.9%), as was the Epstein–Barr virus (34.9%).”


Out of the 252 participants, 168 received antibiotic treatment that lasted at least 3 weeks.

Symptoms improved for nearly 73% of these patients.

93% of participants reported a relapse of symptoms after the completion of antibiotic therapy.

“The type of treatment was oral in most cases (47.6%), or a combination of oral and intravenous therapy (48.8%),” according to the authors.

Intravenous antibiotic therapy was prescribed in only 3.6% of the cases.

Authors Conclude:

  • “It became clear that Lyme disease is often diagnosed very late.”
  • “It appears that people suffering from Lyme disease have significantly lower quality of life and sleep and show cognitive impairments when it comes to attention and memory.”
  • “This study shows that 3.1% of Lyme patients were satisfied with their lives and that 37% scored in the lower third of the quality-of-life scale.”
  • “It was also shown that Lyme patients tend to have depressive symptoms.”
  1. Hündersen F, Forst S, Kasten E. Neuropsychiatric and Psychological Symptoms in Patients with Lyme Disease: A Study of 252 Patients. Healthcare (Basel). 2021 Jun 14;9(6):733. doi: 10.3390/healthcare9060733. PMID: 34198647; PMCID: PMC8232147.



This article, right here, encapsulates dire issues that have remain untouched for over 40 years.

  • Abysmal testing is still relied upon for diagnosis
  • Having the EM rash and remembering a tick bite happen far less than we are being told
  • People are still diagnosed and treated late, even though everyone and their dog knows this is a problem
  • Eight years is a long time to suffer, allowing pathogens to travel everywhere in the human body causing untold damage
  • Three weeks of antibiotics is a complete JOKE and is laughable if the consequences weren’t so dire
  • Most were not tested for coinfections Since testing for coinfections is just as abysmal as for Lyme – these patients saved a lot of money.  The minus, of course, is not understanding that cases with coinfection involvement are far more difficult to treat and require far more medications for a longer period of time. Lyme literate doctors understand this fact and will diagnose and treat clinically (based upon symptoms – not tests alone)
  • The fact their symptoms improved in 3 weeks doesn’t mean they should end treatment.  In fact, for those with a brain, it indicates antibiotic treatment works and should be continued until they don’t work, and then, they should be changed, not stopped as coinfections often need addressing and require different meds
  • 93% relapsing should prove to the deniers once and for all that the measly 21 days of doxycycline clearly isn’t working. 
  • 93% relapsing should also put to rest the myth that only 10-2-% go onto suffer persistent symptoms. When you count those who were diagnosed and treated late, as these patients were, it is an astounding 60% that go on to suffer debilitating symptoms.
  • The life-altering, debilitating symptoms these poor people suffer with show that this 40-year old experiment must end.  This is barbarism on a scale similar to the Tuskagee experiment
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