Why Some Patients Fail Lyme Disease Treatment
Lyme disease treatment failure is more likely when diagnosis and treatment are delayed. A recent study examined how long patients waited before receiving treatment and how these delays affected outcomes.
Investigators reviewed questionnaires from 778 Lyme disease patients treated at the Geisinger Clinic, a large health system in Pennsylvania. The researchers evaluated how long patients were ill before seeking medical attention and the time between seeking care and receiving Lyme disease treatment.
How Treatment Delays Affect Lyme Disease Outcomes
The amount of time between a patient’s initial symptoms and treatment varied widely—from the same day to as long as 15 years.
- Nearly 3 out of 4 patients were treated within 1 month of symptom onset.
- More than 1 in 4 patients were treated more than 1 month after symptoms began.
- About 9% were not treated for at least 6 months after symptoms started.
Delayed diagnosis of Lyme disease increases the risk of treatment complications and persistent symptoms.
Symptoms Often Misdiagnosed
Many patients initially attributed their symptoms to other conditions such as the flu, viral illness, bug bites, allergies, skin problems, muscle strain, arthritis, dehydration, overexertion, stress, or aging.
A self-reported diagnosis of chronic fatigue also increased the likelihood of delayed treatment. The authors noted that similarities between chronic fatigue symptoms and Lyme disease may lead clinicians to miss the early signs of Lyme disease.
Some patients were initially diagnosed with other conditions including viral infections, allergic reactions, shingles, muscle or joint injury, cellulitis, or insect bites.
Socioeconomic Factors Affect Treatment
Socioeconomic barriers also influenced treatment delays. According to the authors, uninsured individuals were more likely to delay seeking medical care compared with those who had private insurance.
Delayed treatment was also more common when patients first consulted a primary care physician rather than visiting an urgent care center or emergency department.
Delayed Treatment and Persistent Symptoms
Patients whose treatment was delayed were more likely to develop Post-Treatment Lyme Disease Syndrome (PTLDS). These individuals may experience ongoing pain, fatigue, impaired cognitive function, and reduced daily functioning.
The authors emphasized that reducing delays in diagnosis and treatment could lower the risk of Lyme disease treatment failure and persistent symptoms.
Editor’s Perspective
Several factors associated with Lyme disease treatment failure are preventable. Earlier recognition of Lyme disease symptoms and prompt treatment may help reduce the risk of persistent illness.
I remain cautious about the term “PTLDS” until reliable testing becomes available to rule out the possibility of persistent infection.
Related Articles:
6 reasons for delayed treatment of Lyme disease
References:
- Hirsch AG, Poulsen MN, Nordberg C, et al. Risk Factors and Outcomes of Treatment Delays in Lyme Disease: A Population-Based Retrospective Cohort Study. Front Med (Lausanne). 2020;7:560018.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
I seriously thought this was going to say, “a person that is more likely to fail Lyme disease treatment is a person who is so forgetful that she/he forgets to order more probiotics for a really long time, and then when they finally are ordered, they arrive, and she/he proceeds to misplace them,
I actually expected this to be included.
I guess maybe grossly delayed treatment and this level of forgetfulness may be similar enough, though.
Hi, I got Lyme in 2015 at age 63 I was doing a lot of trail running in Pa. After many treatments with antibiotics and a pic line of Rocephin I still get symptoms every couple of months. When it comes back I get many strange symptoms: neck pain, headaches, brain fog, foot drop, my fingers trigger all at the same time in the middle of the night it’s all been annoying. When I contracted it I was 63 doing IM triathlons winning my age group, running pikes peak marathon, Rachel Carson 34 mile trail race, anyways I was very healthy. I’m still trying to do some of these things. I am going on 68 in April so yes I’m slowing down but these symptoms, will they ever go away.
Thank you
My symptoms seem to be here to stay, went 15 years without treatment because of miss diagnosis. It took a fall of 20ft, ending up with broken back and shattered ankle before I was treated. Now again Doctors here have no answers or solutions to ease my symptoms. I know I’m not alone…
Hello Dr Cameron,
I have symptons for last 2 years and a half. All started in the eyes, pain behind them and a lot of new floaters. I was under a lot of cortisone at the time due to my colitis ulcerosa. After some months I develop that symptom spectrum called visual snow. It took me a year to get a positive WB, and at that time muscle twitching all over the body (as said, initially eyelids, but after the year suddenly mouth, chest, abdomen, limbs..) that started with herbal treatment toguether with amoxicilin. Since then I went for 8 months of 3 antibiotics by month (changing them each 2 months). That just created flares and some remision phases, now I am with herbs and less flares but still no improvement. As I am in Poland and I cant go to set a visit, just this question, do you think I should go for IV antibiotics? Or do you think it might be more due to excesive neurotoxins in my body? My best way to treat symtomps is heat (infrarred sauna, or long summer days).
Thank you for your answer!!
I can’t say if IV ceftriaxone would be helpful for you. You have to work with your doctor to address the question. Were you checked of Babesia as that parasite needs to be treated with a drug such as atovaquone.
Hi, thank you for your answer. I haven’t been checked foe coinfections, although I believe that I might have bartonella, most of my neuropathy and fasciculations are in calves and feet, as well as some pain in the feet bones. I’ve taken already 5 months of ceftriaxtone, but orally. As said, that medicin lead me to continuous like electric buzz feeling in the legs, as well as dizziness and nause. Anyway, ill check for that babesia and that medicin. Thx
Hi Doctor my lab results just last week came back as Babesia Duncani, how should this be treated ? Thank you
Babesia duncani was first identified in the Western USA. I typically treat my patients with atovaquone. I also treat Lyme and co-infections if present. You will have to work out a treatment plan with your doctor.
I suffer from neuroborreliosis, with very burning nerve pain in the face and upper dentures. My two feet are also constantly numb. What treatment would help?
Many of my patients have numbness of the face and legs related to a tick borne illness. They do not have diabetes. The neurologist cannot find an answer. Some of them have been diagnosed with small fiber neuropathy. I typically recommend including a doctor experienced in treating Lyme disease to come up with a plan for you with followup to determine what treatment works for you.
My situation is that I’m in the 3rd go-round with Lyme… 1st in 1998, was taking medication within 4 hrs of detection. Next in 2001 when I complained of ankles hurting – did IV antibiotics for 30 days (yuk!) now, in search of a diagnosis for a tooth resorption, I again am testing positive! What should I be taking??? Help!!!
I have not read anything helpful on teeth resorption. I typically treat the Lyme disease if it is present.