Lyme Disease and Related Tick-Borne Infections - Complications

Highlights	Diseases with Similar Symptoms	Babesiosis
Introduction	Diagnosis	Resources
Symptoms	Treatment	References
Risk Factors	Prevention
Complications	Ehrlichiosis

Complications

Prompt treatment with antibiotics is very effective in curing Lyme disease in nearly all infected people, including children. A 2003 study showed that the long-term outcome of patients with Lyme disease who are treated with antibiotic therapy is excellent. However, even if Lyme disease has been successfully treated, it may be possible to become reinfected with Lyme disease again at a later date. The risk appears to occur only in patients who had been treated for the rash. In those who also developed arthritic symptoms, the antibody response appears to persist and prevent reinfection.

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Complications of Late-Stage Lyme Disease

People at highest risk for persistent symptoms are those who go the longest before treatment. Fortunately public vigilance has significantly reduced the rates of late-stage Lyme disease. Antibiotics given at late stages will relieve symptoms in most people, although an estimated 10% will continue to have problems. Also at risk for persistent symptoms are those who show evidence of having severe infections. Retreatment at later stages has been shown to be effective in about three quarters of these patients.

Left untreated, Lyme disease can spread (disseminate). The infection may affect almost any part of the body and cause the following complications:

Severe arthritis
Persistent fatigue
Mood disturbances and loss of concentration
Neuropathy (numbness, tingling, or other odds sensations in the hands, arms, feet or legs)
Life-threatening disorders affecting the heart, lungs, or nervous system can occur, but are very rare

Chronic Arthritis. Without treatment, 60% of patients develop intermittent joint inflammation, especially in the knees. After several severe attacks the condition may become chronic, but it often responds to intravenous or long-term oral antibiotics.

About 10% of treated patients experience persistent pain in the joints. Researchers are trying to determine if this represents and actual chronic infection caused by the spirochete or if it is a persistent and abnormal immune response. In the later case, antibiotics are not effective. To date, investigators have not detected higher levels of immune factors ordinarily associated with inflammation, although one study reported increased traffic of B cells into the affected tissues. B cells are important immune factors in producing infection fighters, which can trigger inflammation.