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Lyme disease - chronic persistent

Alternative names

Tertiary Lyme disease; Stage 3 Lyme disease; Late persistent Lyme disease; Chronic Lyme disease


Chronic persistent Lyme disease is a late stage of an inflammatory disease caused by the bacterium Borrelia burgdorferi , which is transmitted by the bite of a deer tick .

Causes, incidence, and risk factors

Tertiary Lyme disease occurs months to years after the initial infection (see Lyme disease for more information). Symptoms include skin, neurological, and musculoskeletal manifestations.


  • joint inflammation in the knees and other large joints
  • chronic arthritis
  • memory loss
  • mood changes
  • sleep disorders

Additional symptoms that may be associated with this disease:

  • numbness and tingling
  • consciousness, decreased
  • confusion
  • abnormal sensitivity to light

Signs and tests

  • An ELISA shows antibodies to Borrelia burgdorferi . A Western blot test is done to confirm ELISA results.
  • A spinal tap will be abnormal if central nervous signs are present.


The objective of treatment is to eliminate the infection by antibiotic therapy. A high dose of penicillin or ceftriaxone is usually required in the late stages of the disease to treat the infection.

Expectations (prognosis)

Symptoms of arthritis may fail to resolve with treatment. Other symptoms should improve with treatment.


  • continued arthritis

Calling your health care provider

Call your health care provider if symptoms develop -- particularly if you have had Lyme disease before, or live or travel in high-risk areas.


Early diagnosis and appropriate antibiotic treatment for primary Lyme disease is the most effective way to prevent tertiary Lyme disease.

Update Date: 2/3/2004

Kenneth Wener, M.D., Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. Review provided by VeriMed Healthcare Network.

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Last updated: Tue, 06 Jan 2009 00:20:03 GMT