Post–Lyme disease syndrome has been reported in approximately 10% of patients after treatment. Although often erroneously called “chronic Lyme disease,” studies have found no microbiologic evidence of chronic or latent infection after appropriate treatment.
Symptoms include fatigue, arthralgia, myalgia, and impairment of memory or cognition that can last for years after treatment of the acute infection.
PLDS is thought to be due to a disordered immunologic response to the preceding infection. Most patients slowly improve over a period of 6 months, and treatment is directed toward symptom amelioration.
Clinical trials have shown no benefit of prolonged antibiotic treatment for post–Lyme disease syndrome. Evaluation for coinfection with another tick-borne pathogen or for a noninfectious cause is indicated; when no alternative diagnosis is found, treatment is symptomatic.
