Can Lyme Disease Come Back After Being Treated?

Lyme disease is one of the most common vector-borne diseases occurring in approximately 300,000 people in United States of America. The disease is caused by the bacteria, but transmitted by the ticks. Mice and deer acts as reservoir of the bacteria. When ticks feed on these reservoirs, the bacterium gets transmitted in ticks and from ticks they infect humans. The symptoms may be fatigue, joint pain, inflammation and rashes. The bacteria can be completely removed from the body by taking the recommended therapy of antibiotics. Certain preventive measures should also be taken to stay away from the disease causing ticks. The prevalence of disease is growing to other parts of the world due to migration of people. In India, the disease is rare but recently cases have of Lyme infections have been reported in India.

Can Lyme Disease Come Back After Being Treated?

Can Lyme Disease Come Back After Being Treated?

The causative agent of the Lyme disease i.e. the Borrelia is difficult to culture in the routine laboratories. The controversy arises that the people who again experienced the symptoms of the Lyme disease have the relapsed Lyme disease or they are again infected by the bacteria. A study conducted concludes that generally the patients are re-infected by the bacteria and there are very rare chances of relapsing of the disease. It is also recommended by the Infectious Disease Society of America that the chronic therapy of antibiotic in the treatment of Lyme disease is not helpful. The patient may also suffer from Post-Treatment Lyme disease syndrome which is referred as the patients will experience the symptoms of Lyme disease such as fatigue or joint pain even after 6 months of completing treatment. The believers of the term “Chronic Lyme disease”, which essentially means that the Lyme disease is not completely treated from the patients, argues that the Post-treatment Lyme Disease Syndrome is the repercussion of the presence of the old bacteria in the body and has not eradicated completely. Further, they also argue that the antimicrobial therapy should be prolonged to treat the chronic Lyme disease.

Various studies are conducted to investigate whether the Post-treatment Lyme disease syndrome is due to recurrence or reinfection and every time investigation concludes that it is reinfection. These studies further concluded that there is complete eradication of bacteria from the body after the recommended treatment. Now the question arises that if the bacteria is completely removed from the body then why there is Post-treatment Lyme disease syndrome. The answer lies in the presence of fragments of bacteria that are non-viable, in the blood of the patient. These fragments act as an antigen to the body, may initiate inflammation process and are responsible for the symptoms even after completion of the treatment. No reproducible results are found that concludes that viable bacteria exist after completion of treatment.


The treatment of the Lyme disease depends upon the severity of infection, the symptoms and the organ affected. Lyme disease may also affect brain and heart and those conditions immediately require medical intervention. The disease is divided in to early Lyme symptoms and late Lyme symptoms. Treatment, if begins early may completely eradicate the infection while if the treatment is started late may prolong the days of treatment and may also increase the severity of infection. The preferred drugs for the treatment of Lyme disease are Ceftin, amoxicillin and doxycycline. Further, if the patient does not experience neurological symptoms or the cardiac abnormalities, oral doxycycline should be preferred over intravenous ceftriaxone. The treatment of late Lyme disease is complicated due to increased severity and in some cases, several rounds of therapy is required to treat the patient.


The recommended therapy of the antibiotics such as doxycycline and amoxicillin are appropriate to treat the patients suffering from Lyme disease. However, the debate continues whether the Lyme disease relapses or the patient is re-infected. Most of the studies conclude that the chances are high that the patient is re-infected. Further, the symptoms of Post-treatment Lyme disease are due to the bodies action against the non-viable fragments of bacteria.

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Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 15, 2019

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