From the Guidelines
Late-stage Lyme disease symptoms to look out for include persistent arthritis, neurological problems, heart rhythm abnormalities, and extreme fatigue, and treatment typically involves extended courses of antibiotics, with intravenous antibiotics being the standard approach for severe cases. The symptoms of late-stage Lyme disease can be severe and debilitating, and may include:
- Persistent arthritis, which can cause joint pain and swelling
- Neurological problems, such as numbness, tingling, cognitive difficulties, and facial palsy
- Heart rhythm abnormalities, which can increase the risk of heart problems
- Extreme fatigue, which can make it difficult to perform daily activities Treatment for late-stage Lyme disease typically involves extended courses of antibiotics, which can help to eradicate the Borrelia burgdorferi bacteria that causes the disease 1. Common IV antibiotics used to treat late-stage Lyme disease include:
- Ceftriaxone (2g daily for 2-4 weeks)
- Cefotaxime
- Penicillin G For less severe manifestations, oral antibiotics may be used, including:
- Doxycycline (100mg twice daily for 2-4 weeks)
- Amoxicillin (500mg three times daily)
- Cefuroxime axetil (500mg twice daily) Symptom management is also crucial, and may include:
- Anti-inflammatory medications for joint pain
- Medications for neuropathic pain
- Supportive therapies like physical therapy Some patients may experience persistent symptoms even after treatment, a condition sometimes called Post-Treatment Lyme Disease Syndrome, which may require ongoing symptom management 1. Early diagnosis and treatment of Lyme disease is ideal, as it can prevent progression to late-stage disease 1. The extended antibiotic courses are necessary because the Borrelia burgdorferi bacteria that causes Lyme disease can persist in tissues and is more difficult to eradicate in later stages of infection.
From the Research
Symptoms of Late-Stage Lyme Disease
- Intermittent swelling and pain of one or more joints, especially the knees 2
- Neurologic manifestations, such as neuropathy or encephalopathy 2
- Late disseminated infection can occur, with symptoms including arthritis, neurologic problems, and heart problems 2
Treatment Options for Late-Stage Lyme Disease
- Intravenous ceftriaxone or penicillin G may be required for late or severe disease 2
- Oral amoxicillin, doxycycline, and cefuroxime axetil are effective for treating early Lyme disease, but may not be as effective for late-stage disease 3, 4, 5, 6
- Ceftriaxone and doxycycline are the most efficient antibiotics for treating Lyme arthritis and neuroborreliosis 6
- Treatment schemes with variations in dosage or duration may not produce convincing results for late Lyme borreliosis 6
Important Considerations
- Diagnosis is usually made clinically, and there is no completely reliable method of diagnosis 2, 6
- Treatment efficacy can be difficult to evaluate due to the unique pathophysiology of late Lyme borreliosis 6
- Preventive measures should be emphasized to patients to help reduce the risk of Lyme disease 2