The Lyme disease controversies continue.

Within both the biomedical and lay community, Lyme disease continues to evoke considerable disagreements, especially regarding its diagnosis, patient management and treatment. A recent article of mine, published in this journal, dealing primarily with therapy for Lyme disease, subsequently led to a highly critical commentary on some of its content. Too often, however, the authors of these criticisms came to premature conclusions based mostly on little or no published data. Instead, they relied almost exclusively on highly speculative theories and on citing the uncorroborated published or unpublished findings and anecdotal reports of others in an attempt to substantiate their weak claims. In this reply account of mine, I respond by providing compelling evidence, derived primarily from the extensive peer-reviewed published literature, that runs counter to most of their key critical concerns. Another goal here is to further clarify certain inconsistencies, related to the epidemiology and microbiology of Lyme disease and its causative agent, including the dubious 'cyst forms', that have an important bearing on therapy.