Internet-based self-diagnosis of Lyme disease caused death in a young woman with systemic lupus erythematosus. https://www.ncbi.nlm.nih.gov/pubmed/30660803 Abstract In the majority of cases, Lyme disease responds well to antibiotic treatment. Nevertheless, some patients may suffer from chronic nonspecific symptoms such as musculoskeletal pain and fatigue, termed as a post-treatment Lyme disease syndrome (PTLDS). Proper understanding and management of PTLDS may prevent from the incorrect diagnosis of patients with autoimmune, neuromuscular or other somatic disorders, where identical symptoms are equally prevalent. We report a 37-year-old female with systemic lupus erythematosus (SLE) who was repeatedly misdiagnosed for a chronic Lyme disease and treated with tetracycline antibiotics before she developed an acute exacerbation of SLE and finally died due to multi-organ failure. The internet encourages patients to ask physicians for serology testing for Lyme disease and to demand further antibiotic treatment. However, there is clear evidence that positive serology does not indicate infection with B.burgdorferi and most importantly, antibiotic therapy for PTLDS is potentially harmful for patients. It is crucial to follow the recent guidelines for diagnosis and treatment of Lyme disease and PTLDS to avoid the repetition of antibiotic regimens and misdiagnosing patients.