If Lyme disease is left untreated, which pattern of complications is most likely to develop over time?

Progression from localized erythema migrans to disseminated involvement causing carditis (AV block), neurologic manifestations (e.g., facial palsy, meningitis), and oligoarticular arthritis, particularly of large joints.

Purely gastrointestinal ulcerative disease with frequent bloody diarrhea and high risk of colon perforation in the first week after infection.

Development of chronic pulmonary fibrosis and restrictive lung disease due to spirochetal colonization of alveolar tissue as the standard outcome.

Rapid fulminant necrotizing fasciitis at the site of the tick bite within 24–48 hours with systemic toxin-mediated shock as the typical course.