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

• A. 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.
• B. Purely gastrointestinal ulcerative disease with frequent bloody diarrhea and high risk of colon perforation in the first week after infection.
• C. Development of chronic pulmonary fibrosis and restrictive lung disease due to spirochetal colonization of alveolar tissue as the standard outcome.
• D. Rapid fulminant necrotizing fasciitis at the site of the tick bite within 24–48 hours with systemic toxin-mediated shock as the typical course.

Answer: (A)