Chronic Persistent Lyme Disease

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Chronic persistent Lyme disease is an inflammatory diseased caused by the bacteria known as Borrelia burgdorferi. This disease is transmitted when an infected deer tick bites a person. This disease may occur up to years after the initial infection. It mostly affects patients who were never treated for Lyme disease, but even those who have been treated may have their disease progress to this stage. This disease may also be referred to as tertiary Lyme disease, late stage Lyme disease, or stage 3 Lyme disease.


This type of Lyme disease can affect several body systems, such as the brain, muscles, cartilage, skin, nervous system, and bones. Symptoms may include:

  • Fatigue
  • Joint inflammation affecting the large joints, like the knees
  • Changes in mood
  • Chronic arthritis
  • Headaches
  • Memory loss
  • Sleep disorders

Other possible symptoms may include:

  • Confusion
  • Numbness and tingling
  • Abnormal sensitivity to light
  • Decreased consciousness


The antibodies to the bacteria responsible for chronic persistent Lyme disease can be checked for using a blood test referred to as ELISA. To confirm the results of this blood test another test known as a Western blot test is done.

If the patient is experiencing central nervous system symptoms, the doctor may perform a spinal tap. This involves obtaining a sample of spinal fluid through inserting a needle into the spine and allowing the fluid to collect into a vial. It is then analyzed in a laboratory.


To fight the infection, antibiotics are administered. In some cases, they will be administered intravenously. Treatment with antibiotics may last as long as 28 days. An additional two to four weeks of antibiotics may be given if the patient’s arthritis symptoms persist. Antibiotics administered orally are used most often. Commonly used antibiotics include amoxicillin, doxycycline, and cefuroxime.

If the patient’s Lyme disease is severe and is affecting his or her nervous system, they may be given two to four weeks of the antibiotic ceftriaxone intravenously.

Even if symptoms persist, treating patients for a long period of time is typically thought to be unhelpful. If there are specific symptoms that are bothersome, the patient’s doctor may focus on treating the symptom to try and make it more tolerable for the patient.

Even with treatment, it is possible for arthritis symptoms to continue. Heart problems are also possible, such as effects on the heart’s electrical system and slow heart rate.

In rare cases, patient’s, even with treatment, will continue to experience symptoms that make daily life or routine activities difficult. This is referred to as post-Lyme disease syndrome. As of today, there is not an effective treatment for this syndrome.


University of Maryland Medical Center. (2009). Lyme Disease – Chronic Persistent Overview. Retrieved on November 22, 2010 from the University of Maryland Medical Center:

MedlinePlus. (2010). Lyme Disease – Chronic Persistent. Retrieved on November 22, 2010 from MedlinePlus: