Lyme Disease - Symptoms

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What are symptoms and signs of Lyme disease?

Lyme disease affects different areas of the body in varying degrees as it progresses. The site where the tick bites the body is where the bacteria enter through the skin. Days to weeks later, as the bacteria spread in the skin away from the initial tick bite, the infection causes an expanding reddish rash that is often associated with "flu-like" symptoms. Later, it can produce abnormalities in the joints, heart, and nervous system.

Lyme disease is medically described in three phases as: (1) early localized disease with skin inflammation; (2) early disseminated disease with heart and nervous system involvement, including palsies and meningitis; and (3) late disease featuring motor and sensory nerve damage and brain inflammation as well as arthritis.

In the early phase of the illness, within days to weeks of the tick bite, the skin around the bite develops an expanding ring of unraised redness. There may be an outer ring of brighter redness with or without a central area of clearing, leading to a "bull's-eye" appearance. This classic initial rash is called "erythema migrans" (formerly called erythema chronicum migrans). Patients often can't recall the tick bite (the ticks can be as small as the periods in this paragraph). Also, they may not have the identifying rash to signal the doctor. The rash may or may not itch. More than one in four patients never even develop a rash. The redness of the skin is often accompanied by generalized fatigue, muscle and joint stiffness and pain, swollen lymph nodes ("swollen glands"), headache, and less often fever, resembling symptoms of a virus infection.

The redness resolves, without treatment, in about a month. Weeks to months after the initial redness of the skin the bacteria and their effects spread throughout the body. Subsequently, disease in the joints, heart, and nervous system can occur.

The later phases of Lyme disease can affect the heart, causing inflammation of the heart muscle. This can result in abnormal heart rhythms and heart failure. The nervous system signs can include facial muscle paralysis (Bell's palsy), abnormal sensation due to disease of peripheral nerves (peripheral neuropathy), meningitis, and confusion. Arthritis, or inflammation in the joints, begins with swelling, stiffness, and pain. Usually, only one or a few joints become affected, most commonly the knees. The arthritis of Lyme disease can look like many other types of inflammatory arthritis and can become chronic.

Researchers have also found that anxiety and depression occur with an increased rate in people with Lyme disease. This is another important aspect of the evaluation and management of this condition.

Return to Lyme Disease

See what others are saying

Comment from: unnoticedbite, 65-74 Male (Patient) Published: December 06

I found a large reddened area on my left inner knee. I saw no hole or bite area. The area swelled and ached. It would swell more overnight than during the day. Thinking it was a spider bite, I waited for the redness to disappear. That took a month or so. I still had knee pain and what seemed like water on the knee. This could be minimized by massaging the area under my knee. I went to see the doctor when pain would wake me up at night. Blood test showed Lyme disease and doxycycline was prescribed for 28 days. After three days I felt better, no pain or swelling.

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Comment from: missy, 55-64 Female (Patient) Published: January 08

I contracted Lyme disease in 2009. My husband and I had been on a camping trip for a week. I got a bite on my foot and it swelled up a little but I thought nothing of it. About 4 days after we got home I felt like I had the flu. About 2 days later I got up one morning and my body was covered with bull eyes, at least 20 but not where I was bit. I called my doctor and was told to keep an eye on them! I panicked and went to urgent care. One look and the doctor asked if I had been bitten by a tick. I never saw a tick but she did the blood work for Lyme which came back positive. She put me on antibiotics even before she got the results. I then went to my primary care because the antibiotics made me sick. He said to stop taking them. Here I am today writing this with severe joint pain, swollen glands, horrible headache, you name it! I am so fatigued all I want to do is sleep. I see my primary care this week.

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