Lyme disease is a tick-borne infectious disease that can become chronic if untreated.
Lyme disease is the most common tick-borne infectious disease in Europe. In Germany alone, according to recent evaluations, around 100,000 new infections occur every year – in 2022, for example, 135,000 new cases were registered with statutory health insurance companies.
The causative agent is the bacterium Borrelia burgdorferi sensu lato, which is transmitted through the bite of the common wood tick (Ixodes ricinus). When detected early, acute Lyme disease is usually well treatable; typical is erythema migrans (migrating redness) – a ring-shaped redness around the bite site that can appear days to weeks after the bite.
Clinical diagnosis is paramount. Laboratory tests can be false-negative and should always be considered in the context of symptoms.
It becomes problematic when Lyme disease is not diagnosed in time – for example because no characteristic skin rash appeared or was overlooked.
Chronic Lyme disease or post-Lyme syndrome (PLS) is often mentioned when symptoms persist despite (or long after) antibiotic therapy. Recent research shows that Borrelia have survival strategies: They can transform into forms that are less sensitive to antibiotics (so-called persisters or biofilm forms).
Laboratory and animal studies found that a combination of three antibiotics (daptomycin, doxycycline and ceftriaxone) was necessary to completely eradicate persistent Borrelia. This research provides a plausible explanation for why about 10–20% of Lyme patients continue to suffer from symptoms after standard therapy.
Ticks rarely transmit only a single pathogen. Learn which co-infections complicate diagnosis.
Symptoms
Malaria-like symptoms, fever episodes, night sweats, anemia
Treatment
Antiprotozoal drugs (not antibiotics)
Symptoms
Vascular inflammation, skin striae, nerve pain, neuropsychiatric symptoms
Treatment
Special antibiotic combination
Symptoms
Immunosuppression, recurrent infections, blood count changes
Treatment
Doxycycline, long-term
Symptoms
Chronic vascular inflammation, heart problems, neurological deficits
Treatment
Combination antibiotics
Chronic infections are often co-infections. We must look not only for Borrelia but also for Rickettsia, Babesia, and other pathogens.
This scientific information is provided for educational and patient guidance purposes only. It does not constitute medical advice, individualized diagnosis, or a promise of cure, and cannot replace a personal consultation with a qualified physician.
Association for the Treatment of Chronic Infections (VBCI e.V.) – Non-Profit Patient Organization.
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