Lyme disease is a tick-borne infection caused by the Borrelia burgdorferi bacteria. The bacteria enter the body through the tick site and then travel through blood and lymph to affect nearly every part of the body. There are three stages of Lyme disease, each with its own set of symptoms. The late stage, also called the tertiary or late disseminated stage, causes symptoms that can be very difficult to eradicate, even when treatment with antibiotics was given at the start of the infection. Antibiotics may be given for a prolonged time and may be given intravenously.
Musculoskeletal Symptoms
Tertiary Lyme disease causes significant joint and muscle symptoms. Arthritis occurs in 60 percent of people with Lyme disease, beginning anywhere from a few months to several years after the initial infection, according to the Merck Manual. Large joints, especially knees, are affected; they often become very swollen, requiring fluid to be aspirated so the joint can bend. They may also be hot to the touch, but don't usually appear reddened. Baker's cysts, fluid-filled swelling behind the knee, may also form and can rupture. Nonsteroidal anti-inflammatory medication helps decrease inflammation in the joints.
Cognitive/Neurological Symptoms
Cognitive changes, or difficulty thinking and carrying out normal activities, also affect people with tertiary Lyme disease. Short-term memory loss, confusion, inability to concentrate on tasks, mood swings and sleep difficulties have all been reported. Numbness and tingling in extremities affect many people with tertiary Lyme disease. Bell's palsy, facial paralysis of the muscles usually affecting only one side of the face, may occur as a late complication of Lyme disease, the Penn State College of Agricultural Sciences states.
Other Symptoms
Overwhelming fatigue and malaise are often part of tertiary Lyme disease. Fever, headache, light sensitivity and rash may accompany tertiary Lyme disease.
