Lyme disease is a bacterial infection caused by Borrelia burgdorferi that is transmitted through the bite of infected blacklegged ticks. If left untreated, Lyme disease can cause serious complications. Here is an overview of what can happen if Lyme disease goes untreated:
Early Localized Lyme Disease
In the early localized stage, which occurs within the first 4 weeks after a tick bite, the bacteria remain near the site of the bite. Symptoms include:
- A bull’s eye shaped rash called erythema migrans (EM) which occurs in 70-80% of infected people.
- Flu-like symptoms such as fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes.
Without treatment, the infection can spread to other parts of the body within days to weeks. The rash will clear up on its own after 3-4 weeks.
Early Disseminated Lyme Disease
In the early disseminated stage, which occurs weeks to months after the tick bite, the bacteria begin to spread through the bloodstream to other parts of the body. Symptoms include:
- Additional EM rashes on other areas of the body.
- Facial or Bell’s palsy – loss of muscle tone or drooping on one or both sides of the face.
- Severe headaches and neck stiffness due to meningitis.
- Pain and swelling in large joints, especially the knees.
- Irregular heart rhythm and dizziness due to carditis.
Without antibiotic treatment, the infection can progress into late disseminated disease within months to years after the initial tick bite.
Late Disseminated Lyme Disease
In the late disseminated stage, the bacteria have spread throughout the body. Symptoms include:
- Severe joint pain and swelling, particularly in the knees.
- Neurological symptoms like numbness, tingling, cognitive deficits, meningitis, weakness or paralysis in the limbs, impaired muscle movement, and poor coordination.
- Heart palpitations and dizziness due to changes in heart rhythm.
- Inflammation of the brain and spinal cord.
- Intermittent arthritis with severe joint pain and swelling, particularly in the large joints like the knees.
Without treatment, late stage Lyme disease can become a chronic condition resulting in debilitating symptoms. However, antibiotics at this stage can still help resolve symptoms.
Post-Treatment Lyme Disease Syndrome
In some cases, symptoms such as fatigue, muscular and joint pain can continue after standard antibiotic treatment. This condition is called post-treatment Lyme disease syndrome (PTLDS). It’s not clear what causes PTLDS, but it is likely due to residual damage to tissues and the immune system that occurred during infection. PTLDS symptoms generally improve over time, although very slowly in some cases. Additional antibiotic treatment does not help PTLDS.
Long-Term Complications
Without treatment, Lyme disease can lead to severe long-term complications such as:
- Chronic Lyme arthritis: Recurring episodes of severe joint swelling and pain, most often in the knees, that can last for months or years. This occurs in about 60% of untreated patients.
- Neurological problems:numbness, tingling, weakness or paralysis in the limbs, cognitive deficits, debilitating headaches, nerve pain, meningitis, and poor coordination.
- Heart abnormalities: Irregular heartbeat, heart palpitations, lightheadedness, fainting, and shortness of breath due to changes in heart rhythm and rate.
- Chronic encephalomyelitis: Inflammation of the brain and spinal cord leading to deficits in memory and cognitive function.
While most cases of Lyme disease can be cured with early antibiotic treatment, delays in diagnosis and treatment increase the risk of these severe complications.
Conclusion
In summary, if Lyme disease is not treated promptly with antibiotics, the initial infection can progress from early to late disseminated disease leading to debilitating symptoms. The bacteria spread throughout the body potentially causing arthritis, neurological problems, heart abnormalities, and chronic encephalomyelitis. While antibiotics are still helpful in the late disseminated stage, they work best when given early in the course of infection. Seeking prompt treatment after a tick bite and noticing the early signs of Lyme disease are crucial in preventing severe complications from this illness.