Medical Health Encyclopedia

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.

Persistent Neurologic Disorders. In general neurologic problems persist in 5% of patients, although some studies have reported much higher rates of up to 50%. Persistent symptoms usually include headache, attention and memory problems, and depression. Patients may also experience neurologic pain, numbness, or abnormalities in the face. Neurologic symptoms generally resolve and improve within a year.

Heart Problems. About 5% of untreated patients experience acute heart events from electrical conduction problems caused by the infection. Heart symptoms can appear within a few days to several months after the onset of disease. They include:

• Arrhythmias (irregular heartbeats)
• Pericarditis (inflammation of the lining of the heart), which occurs in about 5% of patients

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Lyme-related heart problems nearly always resolve without serious consequences within a week. About 30% of patients may need a temporary pacemaker, however. In very rare cases, these heart rhythm abnormalities have been fatal. There is some debate about whether there are any long-term consequences to the heart, such as the development of heart failure in some patients. One study of patients who had had Lyme-related heart effects reported no greater long-term risk for heart problems than in people without a history of Lyme disease.