Chronic Lyme disease is distinct from untreated late-stage Lyme disease, which can cause arthritis, peripheral neuropathy and/or encephalomyelitis. Chronic Lyme disease is also distinct from the post-treatment Lyme disease syndrome (PTLDS), when symptoms linger after standard antibiotic treatments.[16][17] PTLDS is estimated to occur in less than 5% of people who had Lyme disease and were treated.[18] In contrast to these recognized medical conditions, the promotion of chronic lyme disease is a quintessential example of health fraud.[2] In many cases there is no objective evidence that people who believe they have chronic Lyme have ever been infected with Lyme disease: standard diagnostic tests for infection are often negative.[1][19]