Lyme Disease Symptoms

The symptoms of Lyme disease depend on the stage of the disease. You may first notice symptoms weeks to months after the tick bite. If the disease isn't treated, it may progress from mild symptoms to serious, long-term disabilities.

Stage 1 Lyme disease

Early localized Lyme disease develops days to weeks after you become infected. You may have:

• An expanding, circular red rash (erythema migrans). In about a third of people, the rash looks like a bull's eye, with a pale center area surrounded by a bright red rim.
• Flu-like symptoms, with or without the rash. The symptoms include:
  • Lack of energy.
  • Headache and stiff neck.
  • Fever and chills.
  • Muscle and joint pain.
  • Swollen lymph nodes.

In some cases of Lyme disease, the person doesn't notice any symptoms during this stage. Some people have virus-like symptoms only (no rash), or they have no symptoms at all.

Stage 2 Lyme disease

If Lyme disease isn't found and treated while you have early symptoms, or if you don't have early symptoms that trigger the need for treatment, the infection may affect the skin, joints, nervous system, and heart within weeks to months after the infection starts. This is called early disseminated infection. Symptoms may appear 1 to 4 months after infection.

Symptoms may include:

• An expanding, circular rash at the site of the bite. More rashes may appear on other parts of your body as the infection spreads.
• Pain, weakness, or numbness in the arms or legs.
• Not being able to use the muscles of the face.
• Headaches or fainting that keeps happening.
• Poor memory and reduced ability to concentrate.
• Conjunctivitis (pinkeye) or sometimes damage to deep tissue in the eyes.
• Brief episodes of pain, redness, and swelling in one or more large joints. These are most often in the knee. Joint problems are common.
• Rapid heartbeats (palpitations) now and then or, in rare cases, serious heart problems.

Stage 3 Lyme disease

If Lyme disease isn't promptly or effectively treated, damage to the joints, nerves, and brain may develop months or years after you are infected. It's the last and often the most serious stage of the disease. This is called late persistent Lyme disease.

Symptoms at this stage may include:

• Arthritis that most often affects the knee. A small number of people later get chronic Lyme arthritis. It causes repeat episodes of swelling, redness, and fluid buildup in one or more joints that last up to 6 months at a time.
• Numbness and tingling in the hands, feet, or back.
• Feeling very tired.
• Not being able to control the muscles of the face.
• Problems with memory, mood, or sleep, and sometimes problems speaking.
• Heart problems. These are rare, but they can occur months to even years after you are bitten by an infected tick. The most serious heart problems—such as inflammation of the structures surrounding the heart (pericarditis)—usually get better without any lifelong damage. But in some cases, heart problems can be the first sign of Lyme disease in a small number of people who didn't have early symptoms.

Stage 2 and stage 3 symptoms may be the first signs of Lyme disease in people who didn't have a rash or other symptoms of early infection.