Many infectious diseases have a post-infection syndrome, and Lyme disease is no exception.
Purported mechanisms may include:
(1) immunologic
(2) residual damage to nervous system (central, autonomic)
The concept of persistent infection is controversial, especially after adequate antibiotic therapy. However, it is possible that some patients were undiagnosed with Lyme disease and did not receive antibiotic therapy.
Manifestations may include:
(1) chronic fatigue
(2) arthritis or arthralgia
(3) myositis with or without skin lesions (dermatomyositis)
