For once, Twitter actually changed Orac's mind. Chronic Lyme disease is not a fake disease. Rather, it is a fake diagnosis or pseudodiagnosis disconnected from what is really going on physiologically. That's why only quacks use the diagnosis.
Alternative practitioners invent and treat fake diseases like adrenal fatigue and chronic Lyme disease. Unfortunately, as a recent CDC report on complications due to treating chronic Lyme disease with long term antibiotics shows, treating fake diseases can cause harm and, in some cases, even kill.