Complications:

Prompt treatment with antibiotics is very effective in curing Lyme disease in nearly all infected people, including children. However, untreated Lyme disease can lead to complications.

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 about 5% may continue to have problems.

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.

About 60% of untreated patients develop arthritis, which usually affects a knee or other large joint. About 10 - 20% of patients develop neurological or heart problems.

Persistent neurological symptoms include headache, attention and memory problems, and depression. Patients may also experience pain or tingling in legs or arms (peripheral neuropathy), numbness, or facial paralysis (Bell� ' s palsy). Neurologic symptoms generally resolve and improve within a year.

The main heart complications are electrical conduction problems caused by the infection, which can result in an abnormally slow heart rate.

Infections in the Pregnant Patient. The occurrence of any infection during pregnancy is of special concern. While the current research indicates that complications during pregnancy due to Lyme disease are very rare, pregnant women should still adhere scrupulously to preventive measures.

• Some studies indicate that Borrelia burgdorferi may be transmitted to the fetus during pregnancy, with the risk highest during the first trimester. If this occurs, however, it is likely to be very rare and not an issue of great concern. There is no evidence of any severe effects in the offspring of infected pregnant women.
• There are no reports of human infant Lyme disease infection from breastfeeding. Studies on animals, however, have reported transmission of the organism to infant mice through breast milk, but these findings do not appear to be applicable to people.

Post-Lyme Disease Syndrome

Lyme disease is a curable condition. Nearly all patients (95%) improve after a short course of antibiotics. In very rare cases, patients continue to complain of persistent non-specific symptoms, such as fatigue, muscle aches, cognitive problems, and headache lasting years after completing antibiotic treatment for the initial infection.

This syndrome, which resembles chronic fatigue syndrome (CFS) or fibromyalgia, is referred to as post-Lyme disease syndrome. In the past, it has been called “chronic Lyme disease.” However, based on many reviews of scientific literature, researchers and doctors strongly believe that Lyme disease does not have a chronic state. According to the 2006 guidelines from the Infectious Diseases Association of America, post-Lyme disease syndrome is the preferred name for this condition.

Patients are considered to have this syndrome if they still have symptoms 6 months after treatment. Most important, there must be definitive evidence that the patient was originally infected by the B. burgdorferi spirochete. If there is no documented evidence of infection, it could be that the patient never had Lyme disease, or may be experiencing a new or different type of illness. If the patient did have Lyme disease, symptoms should eventually resolve without additional antibiotic treatments.

Doctors strongly advise against prolonged antibiotic treatment. There is no evidence that long-term antibiotics help treat post-Lyme disease syndrome symptoms. In addition, long-term antibiotic treatment carries its own serious risks, such as the development of antibiotic-resistant superbugs.