With the widespread accessibility to information on the Internet, much of which is not necessarily evidence-based, it appears that patients are more frequently consulting with their caregivers about vague somatic complaints that they think are due to exposure to various microbial organisms.  Chronic Lyme disease has become a favorite disease due to some well-publicized celebrities announcing that they are suffering from this disorder.  Patients also complain from the effects of mold exposure (“Toxic mold”), parasite infestations (delusions of parasitosis or Morgellon disease), among others.  Patients can be very insistent, demanding therapies that are not supported by evidence.  This presentation will assist practitioners as to how to appropriately diagnose and counsel patients about these various disorders. 

Learning Objectives

  • Discuss why it is not appropriate to order testing for Lyme disease to help explain patients’ musculoskeletal symptoms when they do not have an appropriate exposure history or physical examination abnormalities.
  • Recognize why prolonged antibiotic therapy is not indicated for individuals who believe they have “chronic Lyme disease.”
  • Learn how to counsel patients regarding the effects of mold exposure.
  • Identify the appropriate evaluation & management of patients with delusional infestations.



Richard J. Hamill, MD

Professor, Departments of Medicine and Molecular Virology & Microbiology 
Vice-Chair for Education, Department of Medicine, Baylor College of Medicine 
Staff Physician, Infectious Diseases Section, Michael E. DeBakey VA Medical Center




The following relevant financial relationships have been disclosed by faculty: 

Richard J. Hamill, MD: No relevant financial relationships disclosed. 

Non-faculty contributors involved in the planning, development, editing, and review of the content have disclosed no relevant financial relationships.

CME/CE Information

AMA PRA Category 1 Credits

Accreditation Statement

Pri-Med Institute is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement

Pri-Med Institute designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For APRNs and PAs, AANPCB and NCCPA accept AMA PRA Category 1 Credit™ as the number of hours of participation (AANPCB) or as Category 1 CME credits (NCCPA).

Commercial Supporter

Not Applicable  

Education Partner

Baylor College of Medicine  

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