Lyme disease is a bacterial infection caused by Borrelia burgdorferi bacteria that is transmitted through the bite of an infected black-legged tick. If Lyme disease is not diagnosed and treated early on, the infection can spread throughout the body and cause serious complications months or even years later.
What are the stages of untreated Lyme disease?
Lyme disease progresses through three stages if left untreated:
- Early localized Lyme disease – Occurs days to weeks after a tick bite. A red rash around the bite site is common.
- Early disseminated Lyme disease – Weeks to months after the bite. The bacteria spread through the bloodstream. Flu-like symptoms, facial palsy, and heart palpitations can occur.
- Late Lyme disease – Months to years after the bite. Arthritis, neurological problems, and chronic symptoms may develop.
The longer Lyme disease goes untreated, the more time the bacteria have to spread and trigger late stage symptoms.
What are the long-term effects of untreated Lyme disease?
Some of the long-term complications that can occur after years of untreated Lyme disease include:
- Chronic joint inflammation (Lyme arthritis) – About 60% of untreated Lyme patients develop recurring arthritis, particularly in the knees. Joint damage can progress over time.
- Neurological symptoms – Nerve pain, numbness, facial palsy, headaches, and trouble concentrating are common years after infection.
- Heart problems – Lyme carditis occurs when Lyme bacteria infect the heart. Heart blockages that require a pacemaker may develop.
- Chronic fatigue – Debilitating fatigue that interferes with normal activities can occur after untreated Lyme.
- Cognitive deficits – Problems with memory, concentration, and executive function similar to early Alzheimer’s dementia.
Can Lyme disease be fatal if left untreated?
Fatalities directly caused by Lyme disease are rare, even when it goes untreated for prolonged periods. However, Lyme carditis can be life-threatening if it causes a dangerous heart rhythm or blockages.
According to one study, the fatality rate for untreated Lyme carditis is about 4-7% if not treated promptly with antibiotics. With appropriate treatment, the vast majority of Lyme carditis cases have good outcomes.
Other life-threatening complications
While not directly fatal, some serious neurological and arthritic complications of untreated Lyme could indirectly contribute to death or severely impact quality of life including:
- Paralysis from neuroborreliosis
- Recurrent severe arthritis requiring joint replacement surgery
- Progressive dementia from encephalopathy
How common are long-term complications of untreated Lyme?
One review found that 6-15% of Lyme disease patients who are untreated in the early stages will go on to develop chronic, debilitating symptoms that last months to years. The most common complications were arthritis, neurologic problems, and chronic fatigue.
According to the CDC, untreated Lyme disease patients have about a 10-20% risk of developing recurring arthritis, neurological issues, or cardiac symptoms after infection.
Risk factors for chronic Lyme disease
- Delayed diagnosis and antibiotic treatment
- Older age
- Compromised immune system
- Multiple tick bites over time
Younger, healthy patients who get diagnosed and treated quickly have the best prognoses with few long lasting effects of Lyme disease.
Can chronic Lyme disease be cured?
There is controversy over whether chronic Lyme disease exists as its own clinical entity. According to the CDC and Infectious Disease Society of America, a 4-6 week course of antibiotics should cure Lyme disease infections, even in later stages.
However, some doctors who treat patients with chronic Lyme disease symptoms lasting over 6 months despite prior antibiotic treatment believe the bacteria may persist in certain patients. More research is still needed.
Treating chronic Lyme disease
Doctors who believe in chronic Lyme disease often prescribe long-term intravenous or oral antibiotics for several months to treat persistent symptoms. The evidence for this is conflicting.
While antibiotics have not been proven to reliably cure ongoing symptoms, some patients report gradual improvements in energy, pain, and neurological symptoms with long-term antibiotic therapy.
What is the best way to prevent chronic Lyme disease?
The key is to prevent Lyme disease infection or catch it very early before it has time to spread and cause lasting damage.
Prevention tips include:
- Avoid wooded and brushy areas with ticks
- Use insect repellent and wear protective clothing
- Check your body for ticks after being outdoors
- Remove attached ticks as soon as possible
Early diagnosis and antibiotic treatment within the first few weeks of infection is crucial to preventing the bacteria from embedding deeper into tissues and causing chronic symptoms.
See a doctor immediately if you develop any rash, flu-like symptoms, joint pain or neurological problems after spending time in tick infested areas. Be sure to tell your doctor about any tick bites.
Conclusion
Lyme disease can cause severe complications like chronic arthritis, heart problems, and neurological symptoms if it goes untreated for months or years after the initial tick bite. While rarely fatal, untreated Lyme can significantly impact quality of life. However, the vast majority of Lyme disease cases can be resolved with early diagnosis and a timely course of antibiotics. It is crucial to prevent tick bites and seek medical care promptly if Lyme disease is suspected to avoid chronic symptoms.