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The Difference Between Chronic Lyme And Late-Stage Lyme Disease

There are several different stages of Lyme disease that differ in both severity and symptoms. The various stages can also determine how easy it is to diagnose the condition and, in turn, which treatment options might be the most effective. Here’s a breakdown of the difference between chronic Lyme and late-stage Lyme disease.

What is Lyme disease?

Lyme disease is caused by a bite from a tick that’s a carrier for the bacterium Borrelia burgdorferi. The first acute stage, also known as early localised disease, occurs within one to two weeks after the tick bite took place. This is when Lyme symptoms first start to appear. These symptoms vary from person to person, but can include:

  • A bullseye rash (typically at the site of the tick bite)
  • Flu-like symptoms (fever, chills, malaise, etc.)
  • Enlarged lymph nodes
  • Sore throat
  • Extreme fatigue
  • Headaches
  • Muscle aches
  • Joint pain

Another early stage of Lyme disease can be considered as early disseminated Lyme disease. It can occur anywhere from a few weeks to several months after the initial tick bite. This stage is marked by evidence of systemic infection (this means that the infection has begun to spread throughout the body, including to other organs.) Additional, more serious symptoms can crop up, such as multiple erythema multiforme lesions, disturbances in heart rhythm, and neurologic symptoms such as numbness, tingling, facial palsies and/or meningitis. Lyme disease in the early stages is most commonly treated with antibiotics.


Image by Free-Photos on Pixabay: Even the acute stage of Lyme disease can make patients feel like they don’t have enough energy to leave their beds.

What is chronic Lyme disease?

Chronic Lyme is also known as post-treatment Lyme disease syndrome (PTLDS). Patients who are diagnosed with chronic Lyme have had treatment for the condition, but still experience symptoms. Genuine diagnosis of chronic Lyme is challenging; many people in the medical community argue that the Lyme bacteria antibodies would be present even if the disease is cleared, but this does not explain why patients are still presenting with serious symptoms. Many individuals with chronic Lyme develop chronic arthritis as well as neurological and cardiac symptoms. Additional medical issues can arise, including:

  • Severe headaches or migraines
  • Vertigo or dizziness
  • Migrating pains in joints and tendons
  • Stiff or aching neck
  • Sleep disturbances (including insomnia)
  • Mental fogginess or concentration issues
  • Severe fatigue
  • Numbness in limbs or hands and feet

At this time, researchers don’t have a definitive answer as to why some patients develop chronic Lyme or PTLDS even after they’ve received antibiotic intervention. Some doctors choose to admit their patients to hospital for further antibiotics or stronger intravenous (IV) antibiotics, but even this course of action is not effective 100% of the time.

What is late-stage Lyme disease?

Late-stage Lyme disease (or late disseminated Lyme disease) is when the condition has gone untreated for an extended period of time. This can happen because patients are misdiagnosed with other medical conditions, or when healthcare professionals haven’t treated the patient for Lyme at all. This can be a somewhat common occurrence, since Lyme disease can still be tricky for some doctors to recognise and effectively diagnose and treat. The symptoms for late-stage Lyme disease can be quite severe (and even life-threatening in some rare cases). Untreated Lyme disease can damage nearly all systems in the body, including the nervous system.

There have been some cases of patients dying due to respiratory failure or kidney failure. Another possibly fatal complication is Lyme carditis. This occurs when the Lyme bacteria has entered the heart tissue, which leads to interference with the normal movement of electrical signals that coordinate the heart’s beating. This is called ‘heart block’ and can progress quickly. Although it can be treated with oral or IV antibiotics or temporary pacemakers, Lyme carditis can be fatal in some rare cases. Late-stage Lyme disease is also associated with more severe psychological symptoms, so there’s an increased risk of suicide.


Image by Allie Smith on Unsplash: Later stages of Lyme disease are often treated with IV antibiotics.

Are chronic Lyme and late-stage Lyme the same?

The basic difference between the two is whether a person is in an advanced stage of Lyme disease and if they have received treatment or not. Both stages have similar, debilitating symptoms that can have a significant impact on a Lyme patient’s day-to-day quality of life. They are equally dangerous, as the patient experiences symptoms in various systems in the body. Detection and diagnosis are both tricky, since not all medical professionals are Lyme literate. Treatment is crucial in both stages to help deter the further spread of the condition and to help the patient get some relief from their symptoms.

The bottom line is that Lyme disease can be incredibly dangerous at any stage past the acute one. Chronic Lyme and late-stage Lyme are similar in that the patient has either not responded to antibiotic treatment or did not receive treatment within a reasonable amount of time. With that in mind, it is crucial that more healthcare professionals get educated about Lyme disease so patients can be accurately diagnosed and treated faster, and therefore won’t have the chance to reach an advanced late stage of the condition. Likewise, there needs to be more research conducted into what causes chronic Lyme when patients are not responsive to treatment. Hopefully, with time, researchers will discover more about why this occurs and how to offer patients with chronic Lyme a chance to completely recover from the diagnosis.

Featured image by Nick Karvounis on Unsplash