Lyme Disease Kidney Failure: A Rare but Serious Complication
IGNORED RASH?
WORSENING SYMPTOMS?
COULD THIS BE DISSEMINATED LYME DISEASE
Lyme disease kidney failure is uncommon but has been reported in the medical literature. This case highlights how ignoring an early rash may lead to serious complications when Lyme disease spreads throughout the body.
In this Inside Lyme Podcast, I discuss the case of a 66-year-old woman who ignored a bull’s-eye rash—a classic sign of Lyme disease—and later developed acute renal failure.
Mishra and colleagues described this case in
“Disseminated Erythema Migrans,”
published in the American Journal of Medicine.
Case Report: Kidney Failure and Disseminated Lyme Disease
Over a two-week period, a 66-year-old woman developed fever and malaise.
One month earlier, she had a tick bite followed by a bull’s-eye rash—which she ignored.
READ MORE:
Lyme disease in a patient with kidney disease
The patient later developed signs of disseminated Lyme disease, including fatigue, fever, and multiple skin lesions.
Early disseminated Lyme disease typically occurs weeks after a tick bite, when infection spreads throughout the body.
Acute Renal Failure in Lyme Disease
The patient was hospitalized with acute renal failure, with a creatinine level of 4.49 mg/dL.
Her Lyme testing was positive by IgM Western blot, consistent with early infection.
She was treated with intravenous ceftriaxone and oral doxycycline.
Her kidney function improved following treatment, along with hydration and medication adjustments.
This case illustrates how Lyme disease—though typically associated with neurologic or musculoskeletal symptoms—can occasionally affect other organ systems.
Why Early Rash Recognition Matters
The erythema migrans rash is often the earliest sign of Lyme disease. When recognized and treated promptly, progression to disseminated infection may be prevented.
For more on early symptoms, see Lyme disease symptoms guide.
Delayed recognition remains a common issue. Learn more about delayed Lyme disease diagnosis.
Can Lyme Disease Affect the Kidneys?
Kidney involvement in Lyme disease is rare in humans but more commonly reported in animals.
Possible mechanisms include:
- Immune-mediated inflammation
- Disseminated infection affecting multiple organs
- Medication-related or secondary complications
Although uncommon, this case highlights the need to consider systemic effects in untreated Lyme disease.
Clinical Perspective
Patients may ignore a tick bite or rash if symptoms initially appear mild or resolve.
However, Lyme disease can progress silently before more serious complications appear.
This case underscores the importance of early recognition and timely treatment.
Clinical Takeaway
Lyme disease kidney failure is rare but highlights the risks of delayed diagnosis.
Ignoring early signs—particularly the erythema migrans rash—may allow infection to spread and affect multiple organ systems.
Early treatment remains the most effective way to prevent serious complications.
Frequently Asked Questions
Can Lyme disease cause kidney failure?
Yes, although rare, Lyme disease has been associated with kidney complications in some cases of disseminated infection.
What is the significance of a bull’s-eye rash?
The erythema migrans rash is an early sign of Lyme disease and should prompt evaluation and treatment.
Can kidney damage from Lyme disease be reversed?
Some patients improve with treatment, especially when diagnosed before permanent damage occurs.
Inside Lyme Podcast Series
This case series is discussed on
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References
- Mishra AK, et al. Disseminated Erythema Migrans. American Journal of Medicine. 2020.
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 was diagnosed with Neuroboreliosis (northern Germany strain) in 2001, at that time the Bulls eye rash measured 10” in diameter. I was diagnosed 4 month later and treated inadequately. Now I have interstitial lung disease- fibrosis, kidney disease high moderate to severe, intermittent Tacacardia, multiple spinal compression Dx, osteoporosis /penia, hereditary angioedrma type 3, intermittent bowel obstructions w/hospital additions several times a year – with symptoms of Ilius, pancreatic enzyme deficiency, mast cell activation syndrome, multiple CC and one Basel cell cancer, and one episode edema of my airway – ICU for 5 days not responding to standard treatment. I have been fortunate to have excellent MD’s for HAE (UCSD) and fibrotic hypersensitive pneumonitis (UWMC) I believe some of this may be related to LD. I am desperate for help. Here in the beautiful Pacific NW on one will even hear the word “Lyme disease”. I need your help Dr Camron.
Respectfully GK
I have patients with serious underlying issues who happen to have Lyme disease. They have improved somewhat with antibiotics but still need to address the remaining issues withe their specialists.